Provider Demographics
NPI:1710181375
Name:ESHAM, DANA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:LYNN
Last Name:ESHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 STATE ROUTE 159 STE G70
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4439 STATE ROUTE 159
Practice Address - Street 2:SUITE 100
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-4393
Practice Address - Fax:740-779-4399
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0026317208000000X
OH35.098519207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
3851657317OtherMYUTMB 3851657317-COMMERCIAL NUMBER
OH0063380Medicaid
OHH108320Medicare PIN