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Individual

SAMUEL J DAISLEY

Active
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Individual

SAMUEL J DAISLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34004448
OH
207Q00000X
Family Medicine Physician
OS006385L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000137900
ANTHEM BCBS
OH
05
—
0679930
—
OH
01
—
092290
HIGHMARK BCBS- OH LOCATIO
PA
01
—
1760701
HIGHMARK BCBS- PA LOCATIO
PA
Enumeration date
02/22/2007
Last updated
12/09/2009
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