Provider Demographics
NPI:1548258312
Name:DAWLEY, DANIEL M (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:DAWLEY
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 1:15100 BIRCHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9773
Mailing Address - Country:US
Mailing Address - Phone:419-423-5351
Mailing Address - Fax:419-423-8967
Practice Address - Street 1:15100 BIRCHAVEN LN
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9773
Practice Address - Country:US
Practice Address - Phone:419-423-5351
Practice Address - Fax:419-423-8967
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045373207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0494595Medicaid
OH0494595Medicaid