Provider Demographics
NPI:1952921710
Name:ODER, DANIEL (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ODER
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 1:1 CHILDREN'S PLAZA
Mailing Address - Street 2:DAYTON CHILDREN'S HOSPITAL, CHERI RUSSELL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404
Mailing Address - Country:US
Mailing Address - Phone:937-641-3433
Mailing Address - Fax:937-641-5941
Practice Address - Street 1:1 CHILDREN'S PLAZA
Practice Address - Street 2:DAYTON CHILDREN'S HOSPITAL, CHERI RUSSELL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404
Practice Address - Country:US
Practice Address - Phone:937-641-3433
Practice Address - Fax:937-641-5941
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program