Organization
THOMAS D NICHOLAS MD DANIEL J DWYER MD
Active
Other names
Rockville Town Square Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J DWYER MD (PARTNER)
(765) 569-2057
Entity
Organization
Contact information
Practice address
111 W HIGH ST, ROCKVILLE, IN 47872-1735
(765) 569-2057
(765) 569-2340
Mailing address
111 W HIGH ST, ROCKVILLE, IN 47872-1735
(765) 569-2057
(765) 569-2340
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD8603
RR MEDICARE
IN
Enumeration date
10/19/2005
Last updated
07/24/2008
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