Individual
MYRA S DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2140 53RD AVE, BETTENDORF, IA 52722-6279
(563) 421-5700
(563) 421-5749
Mailing address
2140 53RD AVE, BETTENDORF, IA 52722-6279
(563) 421-5700
(563) 421-5749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28287
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12352
WELLMARK HEALTH PLAN
IA
01
—
IA01N2
JOHN DEERE HEALTH PLAN
—
Enumeration date
10/07/2005
Last updated
04/30/2021
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