Individual
PATRICK J DALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
1234 E DUPONT RD, SUITE3, FORT WAYNE, IN 46825-1545
(260) 373-7875
(260) 373-9705
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01035420A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641071
ANTHEM
IN
01
—
060070888
RR MEDICARE
IN
05
—
0783488
—
OH
05
—
100085410
—
IN
01
—
P00807503
R.R. MEDICARE
IN
Enumeration date
08/11/2005
Last updated
09/23/2013
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