Provider Demographics
NPI:1225071285
Name:VLAHOVICH, DANNIEL GENE (DO)
Entity Type:Individual
Prefix:
First Name:DANNIEL
Middle Name:GENE
Last Name:VLAHOVICH
Suffix:
Gender:M
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:PO BOX 637999
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7999
Mailing Address - Country:US
Mailing Address - Phone:317-682-2030
Mailing Address - Fax:317-644-5060
Practice Address - Street 1:5471 GEORGETOWN RD
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5793
Practice Address - Country:US
Practice Address - Phone:317-328-6333
Practice Address - Fax:317-328-6330
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000793134OtherBCBS
IN100360810Medicaid
IN719300004Medicare PIN