Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 7272 | AZ |
N | 111NS0005X | Chiropractic Sports Physician | 581 | ID |
NPI | 1134298110 |
---|---|
Provider Name | Dr. Chris M. Mcdaniel |
First Address | Scottsdale, AZ 85255-6413 |
Second Address | Scottsdale, AZ 85255-3541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 01/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0941080 | BCBS (01) | AZ |
11198878 | CAQH ID NUMBER (01) | AZ |
663772 | ACN/UNITED HEALTHCARE (01) | AZ |
U93430 | (02) | AZ |