Individual
DR. MICHAEL D MCDANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9505 CHAPARRAL LN, SHREVEPORT, LA 71118-4307
(318) 687-6894
(318) 687-6894
Mailing address
9505 CHAPARRAL LN, SHREVEPORT, LA 71118-4307
(318) 687-6894
(318) 687-6894
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GO477
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GO477
TEXAS MEDICAL LICENSE NUM
TX
Enumeration date
05/22/2007
Last updated
07/09/2007
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