Basic Information
Provider Information
NPI: 1922412980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HART
FirstName: DANIEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HART
OtherFirstName: DANIEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: BELOIT HEALTH SYSTEM INC
Address2: 1905 E. HUEBBE PARKWAY
City: BELOIT
State: WI
PostalCode: 535111842
CountryCode: US
TelephoneNumber: 6083642200
FaxNumber: 6083637395
Practice Location
Address1: BELOIT MEMORIAL HOSPITAL
Address2: 1969 W. HART ROAD
City: BELOIT
State: WI
PostalCode: 535112230
CountryCode: US
TelephoneNumber: 6083635971
FaxNumber: 6083635737
Other Information
ProviderEnumerationDate: 06/18/2014
LastUpdateDate: 05/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XME138858FLN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X67636-20WIN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X67636-20WIY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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