Provider Demographics
NPI:1699957456
Name:MOTTER, DANIEL FREDERICK (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:FREDERICK
Last Name:MOTTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:N/A
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013882207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102174709Medicaid
MD935531OtherCAREFIRST MD BCBS
PA118478OtherGEISINGER HEALTH PLAN
PA30131839OtherAMERIHEALTH MERCY - WMG
PA20090422OtherAMERIHEALTH MERCY-WMG
PA243906OtherUNISON-WMG
PA9888197OtherAETNA
PA1572764OtherGATEWAY-WMG
PA2053802OtherHIGHMARK BLUE SHIELD
MD034019700Medicaid
PA211192OtherJOHNS HOPKINS
PA50078843OtherCAPITAL BLUE CROSS-WMG
PA30131839OtherAMERIHEALTH MERCY - WMG
PA127929FLTMedicare PIN