Individual
DR. JOHN R. DANIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8053 CLEVELAND PL, MERRILLVILLE, IN 46410-5303
(219) 769-4456
(219) 769-1468
Mailing address
8053 CLEVELAND PL, MERRILLVILLE, IN 46410-5303
(219) 769-4456
(219) 769-1468
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01034603
IN
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
01034603A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095467
ANTHEM
—
05
—
100201750A
—
IN
01
—
240000555
RAILROAD MEDICARE
IN
Enumeration date
02/06/2007
Last updated
07/03/2008
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