Healthcare Provider Details

I. General information

NPI: 1386896470
Provider Name (Legal Business Name): DANIEL RAY WHALEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

IV. Provider business mailing address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

V. Phone/Fax

Practice location:
  • Phone: 513-588-3623
  • Fax: 513-554-4115
Mailing address:
  • Phone: 513-588-3623
  • Fax: 513-554-4115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-097550
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: