Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35-05-7495C | OH |
NPI | 1063483857 |
---|---|
Provider Name | Daniel Warren Chase |
First Address | Lancaster, OH 43130-8185 |
Second Address | Lancaster, OH 43130-8185 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126518 | (05) | OH |
G22348 | (02) | OH |