Provider Demographics
NPI:1003860008
Name:VALLANGEON, DANA S (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:S
Last Name:VALLANGEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2815
Mailing Address - Country:US
Mailing Address - Phone:614-225-0990
Mailing Address - Fax:614-225-0988
Practice Address - Street 1:524B W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2758
Practice Address - Country:US
Practice Address - Phone:614-225-0990
Practice Address - Fax:614-225-0988
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH080177215OtherRAILROAD MEDICARE
OH2121304Medicaid
OH2121304Medicaid
OH080177215OtherRAILROAD MEDICARE