Provider Demographics
NPI:1477780989
Name:DOBAN, DANIEL JOSEPH (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:DOBAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 FREEDOM WAY STE 24
Mailing Address - Street 2:
Mailing Address - City:MIDWAY PARK
Mailing Address - State:NC
Mailing Address - Zip Code:28544-1428
Mailing Address - Country:US
Mailing Address - Phone:910-577-7561
Mailing Address - Fax:910-577-5399
Practice Address - Street 1:175 FREEDOM WAY STE 24
Practice Address - Street 2:
Practice Address - City:MIDWAY PARK
Practice Address - State:NC
Practice Address - Zip Code:28544-1428
Practice Address - Country:US
Practice Address - Phone:910-577-7561
Practice Address - Fax:910-577-5399
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist