Provider Demographics
NPI:1356335236
Name:DANIELL, REBECCA S (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:S
Last Name:DANIELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:LAKE JUNALUSKA
Mailing Address - State:NC
Mailing Address - Zip Code:28745-1330
Mailing Address - Country:US
Mailing Address - Phone:828-564-2490
Mailing Address - Fax:828-564-2494
Practice Address - Street 1:13 HAYWOOD OFFICE PARK
Practice Address - Street 2:BLDG. B, STE. 106
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28785-6998
Practice Address - Country:US
Practice Address - Phone:828-564-2490
Practice Address - Fax:828-564-2494
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9300073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC27051OtherBLUE CROSS
NC8927051Medicaid
NC2074028AOtherMEDICARE ID
0470688OtherUNITED HEALTH CARE
0470688OtherUNITED HEALTH CARE