MEDICARE: DAVID E MCLOUGHLIN 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35-084126	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	:	1619977253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E MCLOUGHLIN MD

Provider Business Mailing Address
First Line	:	803 PARK HILL CT
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45430-1464
Country	:	US
Telephone Number	:	937-279-9777
Fax Number	:	937-279-9332

Provider Business Practice Location Address
First Line	:	2200 PHILADELPHIA DR
Second Line	:	SUITE 301
City	:	DAYTON
State	:	OH
Zip	:	45406-1830
Country	:	US
Telephone Number	:	937-279-9777
Fax Number	:	937-279-9332

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	07/08/2007

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