DR. Dale Roger Tidaback, MD, MPH
NPI #1710963772 in Wright Patterson Afb, Ohio
Provider Information
- NPI Number
- 1710963772
- Entity Type
- Individual
- Name
- DR. Dale Roger Tidaback, MD, MPH
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Preventive Medicine - Aerospace Medicine
- Credential
- MD, MPH
- Enumeration Date
- Dec 21, 2005
- Last Updated
- Dec 2, 2014
Practice Location
- Address
- 4881 SUGAR MAPLE DR
- State
- Ohio
- ZIP Code
- 45433-5529
- Phone
- (703) 994-8148
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Preventive Medicine - Aerospace Medicine — Aerospace Medicine |
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