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Individual

DANIEL WASDAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2600 6TH ST, CANTON, OH 44710
(330) 438-6311
(330) 580-5546
Mailing address
PO BOX 80690, CANTON, OH 44708
(330) 833-5530
(330) 833-6085

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35-065405
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0945884
OH
Enumeration date
09/14/2006
Last updated
07/08/2007
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