Provider Demographics
NPI:1154827624
Name:DAHLIN, ARIELLE AMANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIELLE
Middle Name:AMANDA
Last Name:DAHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ARIELLE
Other - Middle Name:AMANDA
Other - Last Name:D'CUNHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 ROSS CLARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3023
Mailing Address - Country:US
Mailing Address - Phone:334-794-1148
Mailing Address - Fax:334-793-7592
Practice Address - Street 1:1118 ROSS CLARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3023
Practice Address - Country:US
Practice Address - Phone:334-794-1148
Practice Address - Fax:334-793-7592
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42847207R00000X
ALMD.42847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine