Provider Demographics
NPI:1215986377
Name:VILE, DANIEL JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:VILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-0435
Mailing Address - Country:US
Mailing Address - Phone:215-969-7510
Mailing Address - Fax:215-969-7513
Practice Address - Street 1:8012 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2616
Practice Address - Country:US
Practice Address - Phone:215-624-1758
Practice Address - Fax:215-624-3153
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006269L207RI0011X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001412570004Medicaid
PA0549116000OtherBLUE SHIELD
PA0549116000OtherKEYSTONE
PA24078OtherHEALTH PARTNERS
PA5618455OtherAETNA/USHC
PA712838OtherBLUE SHIELD
PA0549116000OtherBLUE SHIELD PC
PA0549116000OtherAMERI HEALTH
PA060052271OtherTRAVELERS MC
PA1028248OtherKEYSTONE MERCY
PAF18671Medicare UPIN
PA001412570004Medicaid