1528058369 NPI number — DANIEL L. MARIER MD

Table of content: LOUISA RODRIGUEZ (NPI 1235650334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528058369 NPI number — DANIEL L. MARIER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARIER
Provider First Name:
DANIEL
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528058369
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 SOUTHGATE
Provider Second Line Business Mailing Address:
SUITE #2
Provider Business Mailing Address City Name:
PENDLETON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97801-3974
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-276-1911
Provider Business Mailing Address Fax Number:
541-276-3577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 SOUTHGATE
Provider Second Line Business Practice Location Address:
SUITE #2
Provider Business Practice Location Address City Name:
PENDLETON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97801-3974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-276-1911
Provider Business Practice Location Address Fax Number:
541-276-3577
Provider Enumeration Date:
10/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  14200 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10067-7 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1174505044 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1174513873 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1871575720 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1609866458 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 1619967460 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com