Individual
MICHELLE RENEE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4660 WILKENS AVE STE 302, BALTIMORE, MD 21229-4845
(443) 693-7246
Mailing address
2 PARK CENTER CT, SUITE 200, OWINGS MILLS, MD 21117-4295
(443) 693-7246
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0004212
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
961012000
—
MD
Enumeration date
11/18/2010
Last updated
04/23/2019
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