Individual
DAN HENRY GOTTWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 W SAINT CLAIR ST, SUITE 1D, WARREN, PA 16365-2197
(814) 726-1921
(814) 726-7881
Mailing address
103 W SAINT CLAIR ST, SUITE 1D, WARREN, PA 16365-2197
(814) 726-1921
(814) 726-7881
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD043717L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012371870001
—
PA
Enumeration date
04/06/2006
Last updated
07/09/2007
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