MEDICARE: DANIEL DADOURIAN 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
1	207RC0000X	Cardiovascular Disease Physician	MD050781L	PA

General Provider Information

NPI Number	:	1396715249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL DADOURIAN MD

Provider Business Mailing Address
First Line	:	207 N BROAD ST
Second Line	:	3RD FLR., ATTN: KIM EDWARDS
City	:	PHILA
State	:	PA
Zip	:	19107-1500
Country	:	US
Telephone Number	:	215-462-7100
Fax Number	:	215-463-3820

Provider Business Practice Location Address
First Line	:	230 N BROAD ST
Second Line	:	7TH FLR., MS 108
City	:	PHILA
State	:	PA
Zip	:	19102-1121
Country	:	US
Telephone Number	:	215-762-3215
Fax Number	:	215-246-5453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	01/23/2008

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Directions to “ DANIEL DADOURIAN MD” Practice Location

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