Individual
TIMOTHY M DALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 1ST AVE, HUNTINGTON, WV 25702-1241
(304) 526-1436
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17317
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719572
BLUE CROSS BLUE SHIELD
WV
05
—
0044836000
—
WV
05
—
2034935
—
OH
01
—
3001165
WORKERS COMPENSATION
WV
05
—
64941990
—
KY
Enumeration date
05/19/2006
Last updated
11/15/2012
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