Provider Demographics
NPI:1528066743
Name:NIEHAUS, DANIEL G (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:NIEHAUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 PRESTIGE PL
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3794
Mailing Address - Country:US
Mailing Address - Phone:937-752-2305
Mailing Address - Fax:937-522-7513
Practice Address - Street 1:903 NW WASHINGTON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6386
Practice Address - Country:US
Practice Address - Phone:513-867-9000
Practice Address - Fax:513-785-3675
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2015-01-08
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Provider Licenses
StateLicense IDTaxonomies
OH35035025N207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0277383Medicaid
OH0277383Medicaid
OH0411055Medicare PIN
OHNI0411054Medicare PIN
OHP00294922Medicare PIN