Basic Information
Provider Information
NPI: 1033422654
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HELZER
FirstName: DANIEL
MiddleName: WILLIAM
NamePrefix: MR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1015 WYANDOTTE AVE
Address2:  
City: ROYAL OAK
State: MI
PostalCode: 480674518
CountryCode: US
TelephoneNumber: 3476682360
FaxNumber:  
Practice Location
Address1: 4201 SAINT ANTOINE ST
Address2: UHC 9C
City: DETROIT
State: MI
PostalCode: 482012153
CountryCode: US
TelephoneNumber: 3137455146
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2010
LastUpdateDate: 02/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X4301097189MIY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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