Individual
DR. SUZANNE DANIELL
Active
Individual
DR. SUZANNE DANIELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT7550
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000007591
BLUE CROSS/SHIELD PIN
MT
01
—
000008287
MEDICARE PART B GRP ID#
MT
05
—
0108836
—
MT
01
—
110174719
RAILROAD MEDICARE PIN#
MT
01
—
1104882232
GLACIER MEDICAL ASSOC NPI
MT
01
—
27D0411341
CLIA ID#--LAB CERT
NH
01
—
7550
MONTANA STATE LICENSE
MT
01
—
810350909
FEIN
MT
01
—
CI2709
RAILROAD MEDICARE GRP #
MT
Enumeration date
03/15/2006
Last updated
05/12/2008
Update your record
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