Individual
DANIEL MARK WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 LAUREL ST, STE 3170, DES MOINES, IA 50314
(515) 283-0463
Mailing address
411 LAUREL ST, STE 3170, DES MOINES, IA 50314
(515) 283-0463
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28024
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073957
—
IA
Enumeration date
01/20/2006
Last updated
10/19/2007
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