Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 2365 | WV |
NPI | 1023171667 |
---|---|
Provider Name | Daniel Irwin Joseph |
First Address | Wheeling, WV 26003-5704 |
Second Address | Wheeling, WV 26003-5704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |