Individual
DR. KENNETH S. DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1290 HOSPITAL DR, ST JOHNSBURY, VT 05819-9205
(802) 748-2984
Mailing address
1290 HOSPITAL DR, SUITE 1, ST JOHNSBURY, VT 05819-9205
(802) 748-2984
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0420006525
VT
208600000X
Surgery Physician
Primary
5957
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005741
—
VT
05
—
3080079
—
NH
Enumeration date
05/10/2006
Last updated
03/06/2020
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