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Individual
DR. DANIEL EVAR EDQUIST
Active
Individual
DR. DANIEL EVAR EDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030213A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085114
BCBS LAPORTE
IN
05
—
100163710
—
IN
01
—
990012813
RR MEDICARE
IN
Enumeration date
10/11/2005
Last updated
04/01/2021
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