Individual
MARK ELLIOTT MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
102 PATRICK STREET PLZ, CHARLESTON, WV 25387-2444
(304) 223-3200
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 399-4405
(304) 399-2526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1980
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WV1906A
MEDICARE
WV
01
—
WV1906B
MEDICARE
WV
Enumeration date
08/31/2006
Last updated
08/28/2025
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