Healthcare Provider Details

I. General information

NPI: 1770513178
Provider Name (Legal Business Name): DANIEL M TANASE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7675 WELLNESS WAY 7675 WELLNESS WAY
WEST CHESTER OH
45069-2509
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8523
  • Fax: 513-475-7327
Mailing address:
  • Phone: 513-245-3104
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35-093215
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number002631
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35093215
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: