Provider Demographics
NPI:1124857883
Name:DANIELS, VIRGEL PAUL
Entity type:Individual
Prefix:
First Name:VIRGEL
Middle Name:PAUL
Last Name:DANIELS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VIRGEL
Other - Middle Name:PAUL
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:135 MERCHANT ST STE 130
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3734
Mailing Address - Country:US
Mailing Address - Phone:513-771-9600
Mailing Address - Fax:513-348-1306
Practice Address - Street 1:250 KNIGHTSBRIDGE DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3167
Practice Address - Country:US
Practice Address - Phone:513-868-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator