Provider Demographics
NPI:1053401950
Name:HARLIN, DANIEL C (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:HARLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-3106
Mailing Address - Country:US
Mailing Address - Phone:504-738-2434
Mailing Address - Fax:504-738-2430
Practice Address - Street 1:621 HICKORY AVE
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-3106
Practice Address - Country:US
Practice Address - Phone:504-738-2434
Practice Address - Fax:504-738-2430
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15480R2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1473499Medicaid
LA4J135Medicare ID - Type UnspecifiedMEDICARE IND NUMBER
LAH93126Medicare UPIN