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NPI Code Detail

MEDICARE: DR. WARREN R DALTON MD

MEDICARE: DR. WARREN R DALTON MD
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
1207P00000XEmergency Medicine PhysicianME92139FL
2207P00000XEmergency Medicine PhysicianA44721CA

General Provider Information

NPI Number : 1356313274
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WARREN R DALTON MD
Provider Business Mailing Address
First Line : 1618 POETS CORNER ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-4839
Country : US
Telephone Number : 210-392-8725
Fax Number :
Provider Business Practice Location Address
First Line : 2484 STANLEY ROAD, SUITE 91, BLDG 2236
Second Line : DEFENSE MEDICAL READINESS TRAINING INSTITUTE
City : FORT SAM HOUSTON
State : TX
Zip : 78234
Country : US
Telephone Number : 210-221-2108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 06/27/2012

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