Individual
DR. DANIEL EARL DETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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