Individual
SHANE DARREN DANIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER BLVD, CHESTER, PA 19013-3902
(610) 874-5257
Mailing address
1208 WAVERLY WALK, PHILADELPHIA, PA 19147-1122
(215) 875-9205
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD424844
PA
Other
Enumeration date
04/06/2007
Last updated
12/02/2008
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