Provider Demographics
NPI:1528058369
Name:MARIER, DANIEL L (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:MARIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SOUTHGATE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3974
Mailing Address - Country:US
Mailing Address - Phone:541-276-1911
Mailing Address - Fax:541-276-3577
Practice Address - Street 1:1100 SOUTHGATE
Practice Address - Street 2:SUITE #2
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3974
Practice Address - Country:US
Practice Address - Phone:541-276-1911
Practice Address - Fax:541-276-3577
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI10067-7Medicaid
OR1174505044OtherMEDICARE RAILROAD
OR1174513873OtherMEDICARE RAILROAD
OR1871575720OtherMEDICARE RAILROAD
OR1609866458OtherMEDICARE RAILROAD
OR1619967460OtherMEDICARE RAILROAD
ORWCGNWCMedicare ID - Type Unspecified
RI10067-7Medicaid