Provider Demographics
NPI:1154348969
Name:MARLEY, DANIEL STEVEN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:STEVEN
Last Name:MARLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 MOOREMONT TERRACE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411
Mailing Address - Country:US
Mailing Address - Phone:309-838-5383
Mailing Address - Fax:
Practice Address - Street 1:613 MOOREMONT TERRACE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:309-838-5383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN69408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL2613OtherMEDICARE GROUP PTAN
ILIL2613024Medicare PIN
ILIL2613OtherMEDICARE GROUP PTAN