Provider Demographics
NPI:1114924677
Name:DAHN, MICHAEL STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:DAHN
Suffix:
Gender:M
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:PO BOX 116336
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6336
Mailing Address - Country:US
Mailing Address - Phone:912-629-7800
Mailing Address - Fax:912-355-5515
Practice Address - Street 1:111 PERSIMMONS ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4779
Practice Address - Country:US
Practice Address - Phone:912-629-7800
Practice Address - Fax:912-355-1414
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0742402086S0129X
SC383282086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC383285Medicaid
CT020001533Medicare PIN
CTF68425Medicare UPIN