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Dr. Daniel Joseph

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NPI Number Detailed Information

Provider Information:

Name: Dr. Daniel Joseph
Gender: M
Provider License Number If Given: 110108

NPI Information:

NPI: 1588663009
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 2/5/2020

Provider Business Mailing Address:

Address: 2201 S BRENTWOOD BLVD
Saint Louis, MO 63144
Phone Number: 3143671181
Fax Number: 3149685117

Provider Business Practice Location Address:

Address: 17 THE BOULEVARD SAINT LOUIS
Saint Louis, MO 63117
Phone Number: 3143671181
Fax Number: 3149685117

Provider Taxonomy:

Primary: 207WX0107X
Secondary (if any):
State: MO

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