Individual
DEMETRIS DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18610 FENKELL ST, DETROIT, MI 48223-2378
(313) 723-6000
(134) 244-0583
Mailing address
PO BOX 746723, ATLANTA, GA 30374-6723
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F08180197
MI
363LF0000X
Family Nurse Practitioner
Primary
4704227963
MI
Other
Enumeration date
10/03/2018
Last updated
09/02/2021
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