Provider Demographics
NPI:1417203365
Name:DAHARSH, ERIC DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DANIEL
Last Name:DAHARSH
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 1:905 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FRIEND
Mailing Address - State:NE
Mailing Address - Zip Code:68359-1133
Mailing Address - Country:US
Mailing Address - Phone:402-947-2541
Mailing Address - Fax:402-947-2951
Practice Address - Street 1:905 2ND ST
Practice Address - Street 2:
Practice Address - City:FRIEND
Practice Address - State:NE
Practice Address - Zip Code:68359-1133
Practice Address - Country:US
Practice Address - Phone:402-947-2541
Practice Address - Fax:402-947-2951
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012035749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine