Individual
DR. DANIEL EARL DETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 WOOD ST, MANSFIELD, OH 44903-2260
(419) 522-2833
(419) 524-1619
Mailing address
215 WOOD ST, OHIOHEALTH SURGICAL SPECIALISTS, MANSFIELD, OH 44903-2260
(419) 552-2833
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35054441
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130383
ANTHEM
OH
01
—
020011318
RAILROAD MEDICARE
OH
05
—
0789080
—
OH
Enumeration date
12/30/2005
Last updated
01/25/2022
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