Doctor Name: | DR. DANIEL CONRAD HAGEN |
NPI Number: | 1841405487 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 02003180A |
Business Practice Address: | Madigan Army Medical Center 9040 Fitzsimmons Tacoma, WA - 98431 |
Business Phone Number: | 2539681716 |
Business Fax Number: | |
Mailing Address: | Madigan Army Medical Center, Department Of Pathology, 9040 Fitzsimmons TACOMA |
State: | WA |
Postal Code: | 98431 |
Phone Number: | 2539681716 |
Fax Number: | |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 02003180A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |