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Individual

DARYL W LIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
239 EDGEWOOD DR, TRANSFER, PA 16154-1817
(724) 646-0400
(724) 646-0413
Mailing address
PO BOX 1088, HERMITAGE, PA 16148-0088
(706) 660-8505
(706) 660-9390

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS003985L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000856690 0009
PA
05
101208491 0001
PA
Enumeration date
11/22/2005
Last updated
01/25/2012
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