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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780661793 | NPPES |
| Ohio | Other | 000000130383 | ANTHEM |
| Ohio | Other | 020011318 | ANTHEM |
| Ohio | MEDICAID | 0789080 | ANTHEM |
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