Basic Information
Provider Information
NPI: 1770560484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIS
FirstName: HENRY
MiddleName: L.
NamePrefix:  
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2544 COURT DR
Address2: STE H
City: GASTONIA
State: NC
PostalCode: 280543450
CountryCode: US
TelephoneNumber: 7048549990
FaxNumber: 7048549045
Practice Location
Address1: 2544 COURT DR
Address2: STE H
City: GASTONIA
State: NC
PostalCode: 280543450
CountryCode: US
TelephoneNumber: 7048549990
FaxNumber: 7048549045
Other Information
ProviderEnumerationDate: 12/23/2005
LastUpdateDate: 09/01/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X200800917NCY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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