Provider Demographics
NPI:1215676440
Name:DANIEL, SHAMARIA MARSHANTE
Entity type:Individual
Prefix:
First Name:SHAMARIA
Middle Name:MARSHANTE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3813 N SHADYWOOD DR APT 416
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-3523
Mailing Address - Country:US
Mailing Address - Phone:140-531-2603
Mailing Address - Fax:
Practice Address - Street 1:3813 N SHADYWOOD DR APT 416
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-3523
Practice Address - Country:US
Practice Address - Phone:140-531-2603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist