Individual
THEODORE A DANIEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20225 E 9 MILE RD, SUITE A, SAINT CLAIR SHORES, MI 48080-1775
(586) 772-1090
(586) 772-4366
Mailing address
20225 E 9 MILE RD, SUITE A, SAINT CLAIR SHORES, MI 48080-1775
(586) 772-1090
(586) 772-4366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301047561
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4373576
—
MI
Enumeration date
03/08/2006
Last updated
04/07/2014
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