Provider Demographics
NPI:1902166044
Name:LEMIEUX, DANIEL ROBERT (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:LEMIEUX
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 1:2736 E NEWTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2656
Mailing Address - Country:US
Mailing Address - Phone:312-925-2979
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTLAKE AVE N STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-6212
Practice Address - Country:US
Practice Address - Phone:920-690-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005434207Q00000X
WI64273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine