Basic Information
Provider Information
NPI: 1194903054
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIELS
FirstName: RODNEY
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 SOUTH STATE STREET
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 EAST MEDICAL CENTER DR
Address2: 6TH FLOOR C.S MOTT CHILDREN'S HOSPITAL
City: ANN ARBOR
State: MI
PostalCode: 481094259
CountryCode: US
TelephoneNumber: 7349364185
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/03/2008
LastUpdateDate: 09/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X4301104025MIN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0203X0101250097VAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
2080P0203X4301104025MIY Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine

No ID Information.


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