Provider Demographics
NPI:1336176338
Name:ACKERMAN, DANIEL WILLIAM (USN IDC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:ACKERMAN
Suffix:
Gender:M
Credentials:USN IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 CHESTERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8690
Mailing Address - Country:US
Mailing Address - Phone:757-495-0654
Mailing Address - Fax:
Practice Address - Street 1:BHC DAM NECK
Practice Address - Street 2:1885 TERRIER AVE, STE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-2298
Practice Address - Country:US
Practice Address - Phone:757-314-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman