Provider Demographics
NPI:1962193086
Name:GIVEN, DANIEL WINFIELD
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WINFIELD
Last Name:GIVEN
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 1:3945 WOODSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1460
Mailing Address - Country:US
Mailing Address - Phone:440-396-6113
Mailing Address - Fax:
Practice Address - Street 1:3945 WOODSTOCK DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1460
Practice Address - Country:US
Practice Address - Phone:440-396-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X
OH3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider