Individual
DR. DANIEL JAY KONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 SHOREWAY DR, SUITE 120, QUEENSTOWN, MD 21658-1666
(410) 827-4001
(410) 827-4333
Mailing address
1111 BENFIELD BLVD, SUITE 200, MILLERSVILLE, MD 21108-3002
(410) 729-5100
(410) 729-5156
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0032353
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032388
JHHC PROVIDER NUMBER
MD
01
—
0927385
AETNA CAPITATED
MD
01
—
110183169
RR MEDICARE
MD
05
—
159031600
—
MD
01
—
248738
MAMSI SPECIALIST
MD
01
—
3086076
CIGNA PIN
MD
01
—
529991-06
CAREFIRST MD RENDERING
MD
01
—
5360473
AETNA FEE FOR SERVICE
MD
01
—
7605-0043
CAREFIRST BLUECHOICE
MD
01
—
848738
MAMSI PRIMARY CARE
MD
01
—
P12855
CAREFIRST MPOS
MD
Enumeration date
08/09/2005
Last updated
05/24/2012
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