Provider Demographics
NPI:1548006398
Name:DANIELS, PAUL DAVID
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:DANIELS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10154 STATE ROUTE 160
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:OH
Mailing Address - Zip Code:45686-8867
Mailing Address - Country:US
Mailing Address - Phone:740-794-0883
Mailing Address - Fax:
Practice Address - Street 1:10154 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:OH
Practice Address - Zip Code:45686-8867
Practice Address - Country:US
Practice Address - Phone:740-794-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant