Basic Information
| Provider Information | |||||||||
| NPI: | 1922082577 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIDDINS | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007495191 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30265 COMMERCE DR UNIT 206 | ||||||||
| Address2: | |||||||||
| City: | MILLSBORO | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199663595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027328400 | ||||||||
| FaxNumber: | 3029346705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C1-0007309 | DE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 193991 | 01 | NC | MEDCOST, | OTHER | 142M0 | 01 | NC | BCBS OF NC | OTHER | 203242 | 01 | NC | MEDCOST | OTHER | 5904827 | 05 | NC | MEDICAID |