Provider Demographics
NPI:1326017336
Name:CHAROUS, DANIEL D (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:CHAROUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13555 W MCDOWELL RD STE 209
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2628
Mailing Address - Country:US
Mailing Address - Phone:623-512-4199
Mailing Address - Fax:623-512-4176
Practice Address - Street 1:13555 W MCDOWELL RD STE 209
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-512-4199
Practice Address - Fax:623-512-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2020-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ33826207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102994Medicare PIN
AZI29040Medicare UPIN