Individual
DR. CHARLES DOUGLAS DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1234 FRANKLIN RD SW, ROANOKE, VA 24016-4606
(540) 345-1561
(540) 345-2112
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101236633
VA
208800000X
Urology Physician
Primary
0101236633
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010085390
—
VA
Enumeration date
06/16/2005
Last updated
10/21/2022
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