Individual
DANIEL L DUELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA -C
Contact information
Practice address
4 MEMORIAL DR STE 130, ALTON, IL 62002-6704
(618) 463-7600
(618) 463-7601
Mailing address
PO BOX 959203, SAINT LOUIS, MO 63195-9203
(618) 463-7600
(618) 463-7601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110001116
VA
363A00000X
Physician Assistant
085007546
IL
363A00000X
Physician Assistant
Primary
2021038900
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970018319
RAIL ROAD MEDICARE PIN
VA
Enumeration date
11/14/2005
Last updated
10/30/2025
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