Basic Information
Provider Information
NPI: 1558789990
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VELDHEER
FirstName: DANIEL
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 932759
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441930015
CountryCode: US
TelephoneNumber: 8662827905
FaxNumber: 8007310751
Practice Location
Address1: 3533 SOUTHERN BLVD STE 3400
Address2:  
City: KETTERING
State: OH
PostalCode: 454291288
CountryCode: US
TelephoneNumber: 9372938228
FaxNumber: 9372938229
Other Information
ProviderEnumerationDate: 04/02/2014
LastUpdateDate: 10/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X35.134914OHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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