Basic Information
Provider Information
NPI: 1356549158
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASE
FirstName: DANIEL
MiddleName: S.
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 629-D LOWTHER ROAD
Address2:  
City: LEWISBERRY
State: PA
PostalCode: 173399527
CountryCode: US
TelephoneNumber: 7179325200
FaxNumber: 7179323095
Practice Location
Address1: 629-D LOWTHER ROAD
Address2:  
City: LEWISBERRY
State: PA
PostalCode: 173399527
CountryCode: US
TelephoneNumber: 7179325200
FaxNumber: 7179323095
Other Information
ProviderEnumerationDate: 07/03/2007
LastUpdateDate: 05/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X02002930AINN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XOS016018PAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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