Healthcare Provider Details

I. General information

NPI: 1790948388
Provider Name (Legal Business Name): DANIEL JOHN HARMON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE BLDG A40
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE BLDG A40
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-491-7448
  • Fax:
Mailing address:
  • Phone: 216-491-7448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberOS12784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: