Basic Information
| Provider Information | |||||||||
| NPI: | 1053721647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRACEY | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | NICHOLAS | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3160 BIOINFORMATICS CAMPUS BOX 7055 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102562749 | ||||||||
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| Practice Location | |||||||||
| Address1: | 102 MASON FARM RD | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275995848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199663340 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2014 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | DR.0061693 | CO | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 390200000X | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207XS0114X | 2020-02443 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery |
No ID Information.