Waller, Daniel Mark

Waller, Daniel Mark is an individual health care provider with primary practice located at 411 Laurel St Ste 3170, Des Moines IA 50314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Waller, Daniel Mark can be contacted via phone (515) 283-0463.

Contact Information

Primary practice address
411 Laurel St Ste 3170 Des Moines IA 50314
Phone: (515) 283-0463
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 28024 Iowa

Profile Details

NPI number 1174503528
LBN Legal business name Waller, Daniel Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Oct 19th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174503528 NPPES
Iowa MEDICAID 0073957

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