Provider Demographics
NPI:1780659896
Name:DAHL, LYNN F (DO)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:F
Last Name:DAHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 COLISEUM DR
Mailing Address - Street 2:STE 340
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666
Mailing Address - Country:US
Mailing Address - Phone:757-827-2230
Mailing Address - Fax:757-827-2150
Practice Address - Street 1:4000 COLISEUM DR
Practice Address - Street 2:STE 340
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666
Practice Address - Country:US
Practice Address - Phone:757-827-2230
Practice Address - Fax:757-827-2150
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037200207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16388Medicare UPIN
009217S33Medicare ID - Type Unspecified