Provider Demographics
NPI:1982695573
Name:LOO, DANIEL S (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:LOO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:31 ROCHE BROS WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1032
Mailing Address - Country:US
Mailing Address - Phone:508-535-3376
Mailing Address - Fax:508-535-3376
Practice Address - Street 1:31 ROCHE BROS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1032
Practice Address - Country:US
Practice Address - Phone:508-535-3376
Practice Address - Fax:508-535-3377
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2016-09-09
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Provider Licenses
StateLicense IDTaxonomies
MA161035207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3198421Medicaid
MA3198421Medicaid
MA3198421Medicaid