Healthcare Provider Details

I. General information

NPI: 1295268589
Provider Name (Legal Business Name): KARA DANIELLE SZLAG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W TECH RD STE 120
MIAMISBURG OH
45342-0956
US

IV. Provider business mailing address

PO BOX 933432
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-748-6116
  • Fax: 937-291-6956
Mailing address:
  • Phone: 937-641-5072
  • Fax: 937-641-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35144675
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: