MEDICARE: ELLEN DUGAN DAUT 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD011373E	PA

General Provider Information

NPI Number	:	1891796470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN DUGAN DAUT M.D.

Provider Business Mailing Address
First Line	:	501 E MAIN ST
Second Line	:
City	:	WAYNESBORO
State	:	PA
Zip	:	17268-2353
Country	:	US
Telephone Number	:	717-765-4000
Fax Number	:	717-765-3447

Provider Business Practice Location Address
First Line	:	501 E MAIN ST
Second Line	:
City	:	WAYNESBORO
State	:	PA
Zip	:	17268-2353
Country	:	US
Telephone Number	:	717-765-4000
Fax Number	:	717-765-3447

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	01/02/2008

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