Individual
DANIEL IDELKOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(571) 801-0731
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(571) 801-0731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-24184
HI
208D00000X
General Practice Physician
MD-24184
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2022
Last updated
08/15/2025
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