Provider Demographics
NPI:1619084779
Name:HALE, DANIEL ESTEN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ESTEN
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:905 W GOVERNOR RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2307
Mailing Address - Country:US
Mailing Address - Phone:717-531-4751
Mailing Address - Fax:717-531-6139
Practice Address - Street 1:905 W GOVERNOR RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2307
Practice Address - Country:US
Practice Address - Phone:717-531-4751
Practice Address - Fax:717-531-6139
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027144E2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103049602Medicaid
TX103049601OtherCIDC
TX103049601OtherCIDC
TX103049602Medicaid