Provider Demographics
NPI:1861602088
Name:MARICHAL, DANIEL ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALAN
Last Name:MARICHAL
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 1:1303 SW FIRST AMERICAN PLACE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4059
Mailing Address - Country:US
Mailing Address - Phone:785-234-2306
Mailing Address - Fax:785-234-2550
Practice Address - Street 1:1303 SW FIRST AMERICAN PL
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4059
Practice Address - Country:US
Practice Address - Phone:785-234-2306
Practice Address - Fax:785-234-2550
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM74022085R0202X
NE259692085R0202X
KS04-343082085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200656660AMedicaid
KS1861602088OtherBCBS
KS110357008Medicare PIN