Individual
MR. DANIEL PATRICK WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
525 W SWANNANOA AVE, LIBERTY, NC 27298-3136
(336) 622-4850
(336) 622-4855
Mailing address
218 FOUST ST STE C, ASHEBORO, NC 27203-5476
(336) 625-2333
(336) 625-5511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001012527
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427628098
—
NC
Enumeration date
06/28/2021
Last updated
10/25/2022
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