Doctor Name: | DR. DANIEL G. BASEMAN |
NPI Number: | 1194905984 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 70 Neely Rd Brevard, NC - 287124267 |
Business Phone Number: | 8288835620 |
Business Fax Number: | 8288848801 |
Mailing Address: | 2234 Colonial Blvd., FORT MYERS |
State: | FL |
Postal Code: | 33907 |
Phone Number: | 2399317342 |
Fax Number: | 2399317385 |
NPI Enumeration Date: | 11/08/2007 |
NPI Last Update Date: | 01/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |