Individual provider · Type 1 NPI

Israel Daniel Large, MD

Student in an Organized Health Care Education/Training Program · Grandview, MO

NPI number 1609616259 Active

Practice location

13013 Fuller Ave Ste A
Grandview, MO 64030-2687

Call (915) 867-0499 Map

Mailing address

1501 E Whitton Ave Apt 302
Phoenix, AZ 85014-5180

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609616259

Israel Daniel Large, MD's National Provider Identifier is 1609616259, issued on May 30, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Grandview, MO. The record was last updated on Dec 2, 2024.