Individual
WILLIAM JOHN DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
227 MEDICAL PARK DR STE 101, BRIDGEPORT, WV 26330
(681) 342-3500
Mailing address
2673 DAVISSON RUN RD STE 303, CLARKSBURG, WV 26301-6838
(800) 541-4009
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25876
WV
207X00000X
Orthopaedic Surgery Physician
4301089903
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301089903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810027497
WV MEDICAID
WV
01
—
WV4392A
WV MEDICARE
WV
Enumeration date
05/25/2007
Last updated
04/05/2022
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