Detrich, Daniel Earl

Detrich, Daniel Earl is an individual health care provider with primary practice located at 215 Wood St , Mansfield OH 44903-2260. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Detrich, Daniel Earl can be contacted via phone (419) 522-2833.

Contact Information

Primary practice address
215 Wood St Mansfield OH 44903-2260
Phone: (419) 522-2833
Fax: (419) 524-1619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35054441 Ohio

Profile Details

NPI number 1780661793
LBN Legal business name Detrich, Daniel Earl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jan 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780661793 NPPES
Ohio Other 000000130383 ANTHEM
Ohio Other 020011318 ANTHEM
Ohio MEDICAID 0789080 ANTHEM

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