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Individual
JEANETTE R MCDANIEL
Active
Individual
JEANETTE R MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0034935
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48402160
—
MD
Enumeration date
03/07/2006
Last updated
09/06/2012
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