Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125.054103 | IL |
N | 111NI0900X | Internist | 125.054103 | IL |
N | 207U00000X | Nuclear Medicine Specialist | 10237201-1205 | UT |
NPI | 1104073386 |
---|---|
Provider Name | Dr. Adam Christopher Robert Danielson |
First Address | Murray, UT 84107-5838 |
Second Address | Park Ridge, IL 60068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 01/03/2019 |