Individual
DANIEL J SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 446-4695
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02004278A
IN
207L00000X
Anesthesiology Physician
34006533
OH
207L00000X
Anesthesiology Physician
OS8034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050062965
RAILROAD MEDICARE
—
05
—
0889776
—
OH
05
—
200116460
—
IN
05
—
2001783
—
IN
01
—
264430H13
MEDICARE PTAN
IN
05
—
65954084
—
KY
01
—
815500607
MEDICARE PTAN
IN
Enumeration date
08/10/2005
Last updated
04/02/2024
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