Provider Demographics
NPI:1215966551
Name:CHARNEY, DANIEL BRUCE (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRUCE
Last Name:CHARNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E HOME RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2708
Mailing Address - Country:US
Mailing Address - Phone:937-390-6584
Mailing Address - Fax:937-390-2250
Practice Address - Street 1:415 E HOME RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2708
Practice Address - Country:US
Practice Address - Phone:937-390-6584
Practice Address - Fax:937-390-2250
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002122213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist