Healthcare Provider Details

I. General information

NPI: 1598732646
Provider Name (Legal Business Name): DANIEL J MCLAUGHLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18099 LORAIN AVE SUITE 545
CLEVELAND OH
44111-5610
US

IV. Provider business mailing address

PO BOX 74692
CLEVELAND OH
44194-0002
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-9669
  • Fax: 216-476-4818
Mailing address:
  • Phone: 440-895-5021
  • Fax: 440-895-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35-059904
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: