Provider Demographics
NPI:1194485243
Name:SMITH, DANIEL KAMM
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KAMM
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 RALSTON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4440
Mailing Address - Country:US
Mailing Address - Phone:530-903-6259
Mailing Address - Fax:
Practice Address - Street 1:3325 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-7913
Practice Address - Country:US
Practice Address - Phone:775-887-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant