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Individual

KEVIN A DANAHEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
230 E DAY RD, 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941
Mailing address
230 E DAY RD, 100, MISHAWAKA, IN 46545-3408
(574) 271-3939
(574) 271-3941

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002620A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100363220A
IN
01
18002620A
OPTOMETRIST LICENSE
IN
01
P00014931
RR MEDICARE
IN
Enumeration date
12/23/2005
Last updated
03/21/2013
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