Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 36-001383 | OH |
N | 111NR0200X | Radiology | 36-001383 | OH |
N | 213ER0200X | Radiology | 36-001383 | OH |
N | 2081S0010X | Sports Medicine | 36-001383 | OH |
N | 213ES0000X | Sports Medicine | 36-001383 | OH |
N | 213ES0103X | Foot & Ankle Surgery | 36-001383 | OH |
NPI | 1942206875 |
---|---|
Provider Name | Dr. David D Dull |
First Address | Youngstown, OH 44505-1739 |
Second Address | Youngstown, OH 44505-1739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 20/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0022979 | (05) | OH |
T80305 | (02) | OH |