Provider Demographics
NPI:1871544148
Name:GERARD, DANIELA S (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:S
Last Name:GERARD
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7059
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-7059
Mailing Address - Country:US
Mailing Address - Phone:307-689-7531
Mailing Address - Fax:307-248-9640
Practice Address - Street 1:801 E 4TH ST STE 17
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4061
Practice Address - Country:US
Practice Address - Phone:307-670-9200
Practice Address - Fax:307-248-9640
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7204A207P00000X, 207R00000X
CODR.0054736207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H57782Medicare UPIN