MEDICARE: DR. JAMES MELVIN DAHLE 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	207P00000X	Emergency Medicine Physician	34192	AZ

General Provider Information

NPI Number	:	1811963242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MELVIN DAHLE MD

Provider Business Mailing Address
First Line	:	2005 E EDISON ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-3801
Country	:	US
Telephone Number	:	520-320-9556
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 E EDISON ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-3801
Country	:	US
Telephone Number	:	520-320-9556
Fax Number	:

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

Provider Enumeration Date	:	02/25/2006
Last Update Date	:	08/28/2008

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