MEDICARE: DALE J. LAHUE M.D.

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	207R00000X	Internal Medicine Physician	35052428	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487696357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALE J. LAHUE M.D.

Provider Business Mailing Address
First Line	:	6949 GOOD SAMARITAN DR
Second Line	:	SUITE 210
City	:	CINCINNATI
State	:	OH
Zip	:	45247-5204
Country	:	US
Telephone Number	:	513-931-2400
Fax Number	:	513-931-0132

Provider Business Practice Location Address
First Line	:	6949 GOOD SAMARITAN DR
Second Line	:	SUITE 210
City	:	CINCINNATI
State	:	OH
Zip	:	45247-5204
Country	:	US
Telephone Number	:	513-931-2400
Fax Number	:	513-931-0132

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/21/2011

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Directions to “ DALE J. LAHUE M.D.” Practice Location

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