Basic Information
| Provider Information | |||||||||
| NPI: | 1265624092 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL NADIG MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1135 116TH AVE NE #550 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980044623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256881916 | ||||||||
| FaxNumber: | 4256881901 | ||||||||
| Practice Location | |||||||||
| Address1: | 1135 116TH AVE NE #550 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980044623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256881916 | ||||||||
| FaxNumber: | 4256881901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2007 | ||||||||
| LastUpdateDate: | 02/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | LEVITSIS | ||||||||
| AuthorizedOfficialFirstName: | CAT | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4256881916 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD00036958 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2271NA | 01 | WA | REGENCE BLUE SHIELD | OTHER | 0224318 | 01 | WA | DEPT OF L&I | OTHER |