Individual
DR. DANIEL JOHN MCKERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
735 S SHOOP AVE, WAUSEON, OH 43567-1735
(419) 335-2663
(419) 335-9615
Mailing address
735 S SHOOP AVE, WAUSEON, OH 43567-1735
(419) 335-2663
(419) 335-9615
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
68947
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
68947
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000231279
ANTHEM
OH
01
—
000000231294
ANTHEM
OH
01
—
000000566680
ANTHEM
OH
01
—
02080
PARAMOUNT HEALTH INSURANC
OH
05
—
0826271
—
HI
05
—
0826271
—
OH
01
—
200044061
RAILROAD MEDICARE
OH
01
—
200044062
RAILROAD MEDICARE
OH
01
—
4651433
AETNA
OH
01
—
P00685936
MEDICARE RAILROAD
OH
Enumeration date
10/06/2006
Last updated
01/08/2016
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