Provider Demographics
NPI:1326291568
Name:DAITCH, HAROLD J (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:J
Last Name:DAITCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4154 NEARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2139
Mailing Address - Country:US
Mailing Address - Phone:248-540-2088
Mailing Address - Fax:248-540-2089
Practice Address - Street 1:4154 NEARBROOK RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2139
Practice Address - Country:US
Practice Address - Phone:248-540-2088
Practice Address - Fax:248-540-2089
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI227702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology