Provider Demographics
NPI:1487795167
Name:HUNSICKER, DANIEL C (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:HUNSICKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11503 HOLT RD
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21087-1353
Mailing Address - Country:US
Mailing Address - Phone:410-592-9393
Mailing Address - Fax:410-592-6483
Practice Address - Street 1:698 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4264
Practice Address - Country:US
Practice Address - Phone:410-879-0044
Practice Address - Fax:410-893-6871
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02929Medicare UPIN