Provider Demographics
NPI:1518995323
Name:CAIN, DANIEL JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:CAIN
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 1:123 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6606
Mailing Address - Country:US
Mailing Address - Phone:330-832-2229
Mailing Address - Fax:330-833-4247
Practice Address - Street 1:123 3RD ST SE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6606
Practice Address - Country:US
Practice Address - Phone:330-832-2229
Practice Address - Fax:330-833-4247
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005514C207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0156450Medicaid
OHCA0781694Medicare ID - Type Unspecified
OH0156450Medicaid