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Individual

DANIEL L SOUTHREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 893-7246
(215) 893-7270
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 893-7246
(215) 893-7270

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
278076
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD469916
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110152585A
MA
Enumeration date
06/05/2015
Last updated
12/08/2025
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