Provider Demographics
NPI:1891744348
Name:DAINES, MICHAEL OWEN (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:OWEN
Last Name:DAINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 E ELVIRA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-7214
Mailing Address - Country:US
Mailing Address - Phone:520-626-7780
Mailing Address - Fax:520-626-9465
Practice Address - Street 1:535 N WILMOT RD
Practice Address - Street 2:SUITE #101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711
Practice Address - Country:US
Practice Address - Phone:520-694-9988
Practice Address - Fax:520-694-9917
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.077542207K00000X
AZ362812080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology