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NPI Code Detail

MEDICARE: DANIEL PATRICK BRIDGEO PHD

MEDICARE: DANIEL PATRICK BRIDGEO PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist5524OH

General Provider Information

NPI Number : 1073537106
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL PATRICK BRIDGEO PHD
Provider Business Mailing Address
First Line : 5747 LONGFORD DR
Second Line :
City : DUBLIN
State : OH
Zip : 43016-4167
Country : US
Telephone Number : 614-210-0788
Fax Number :
Provider Business Practice Location Address
First Line : 1301 N HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2460
Country : US
Telephone Number : 614-299-6600
Fax Number : 614-421-3111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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Directions to “ DANIEL PATRICK BRIDGEO PHD” Practice Location

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