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Individual

ROBERT MASON DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5360 TWIN HICKORY RD, GLEN ALLEN, VA 23059-5682
(804) 346-3200
(804) 346-4075
Mailing address
1800 GLENSIDE DR, SUITE 105, RICHMOND, VA 23226-3769
(804) 288-0399
(804) 285-0088

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101054530
VA
207Q00000X
Family Medicine Physician
Primary
0101054530
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005635152
VA
01
080182278
RAILROAD MEDICARE
VA
01
186471
ANTHEM
VA
05
1922069889
VA
Enumeration date
03/30/2006
Last updated
09/20/2011
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