Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2010017408 | MO |
NPI | 1023329216 |
---|---|
Provider Name | Dr. Matthew C. Daggett |
First Address | Lees Summit, MO 64063-1041 |
Second Address | Lees Summit, MO 64063-1041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 01/08/2016 |