Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 1501 | OH |
Y | 213ER0200X | Radiology | 1501 | OH |
NPI | 1518020171 |
---|---|
Provider Name | Dr. Edward James Dailey |
First Address | Canton, OH 44735-6952 |
Second Address | Canton, OH 44718-1473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 16/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0749971 | (05) | OH |
U28733 | (02) | OH |