Provider Demographics
NPI:1093712457
Name:DALY, DARLENE FRANCES (DO)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:FRANCES
Last Name:DALY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 DAVISON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2909
Mailing Address - Country:US
Mailing Address - Phone:810-969-4434
Mailing Address - Fax:810-969-4438
Practice Address - Street 1:3257 DAVISON RD STE 203
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2581
Practice Address - Country:US
Practice Address - Phone:810-969-4434
Practice Address - Fax:810-969-4438
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011277207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4177430Medicaid
MIOM94010Medicare ID - Type Unspecified
MI4177430Medicaid