Provider Demographics
NPI:1114955531
Name:CADIGAN, DANIEL G (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:CADIGAN
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 1:2861 E HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-2665
Mailing Address - Country:US
Mailing Address - Phone:419-732-1833
Mailing Address - Fax:419-732-0383
Practice Address - Street 1:2861 E HARBOR RD
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-2665
Practice Address - Country:US
Practice Address - Phone:419-732-1833
Practice Address - Fax:419-732-0383
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-8863-C207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0186945Medicaid
OHG16714Medicare UPIN
0851802Medicare PIN