Provider Demographics
NPI:1194173864
Name:DAGLI, NISHANT (MD)
Entity type:Individual
Prefix:
First Name:NISHANT
Middle Name:
Last Name:DAGLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1072 EAGLETON BLVD
Practice Address - Street 2:STE A
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9195
Practice Address - Country:US
Practice Address - Phone:740-852-2568
Practice Address - Fax:740-852-2583
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138678207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine