Provider Demographics
NPI:1528447752
Name:ANDERSON, DANIEL T (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:340 YORK RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3180
Practice Address - Country:US
Practice Address - Phone:717-218-3920
Practice Address - Fax:717-218-3921
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY292601208000000X
PAMD466575208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics