Provider Demographics
NPI:1447520515
Name:STEVENS, DANIEL ANDREW
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANDREW
Last Name:STEVENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:MEYER 4-181
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-614-4451
Mailing Address - Fax:410-614-8761
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 4-181
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-550-3350
Practice Address - Fax:410-614-8761
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program