Individual
GERALD H MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1646 LOWER CENTREVILLE RD, CENTREVILLE, MS 39631-4518
(601) 645-5473
Mailing address
1646 LOWER CENTREVILLE RD, CENTREVILLE, MS 39631-4518
(601) 645-5473
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R539686
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110285
—
MS
01
—
P00245327
RAILROAD MEDICARE
MS
Enumeration date
06/23/2006
Last updated
05/01/2013
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