Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | 08001557A | IN |
N | 207Q00000X | Family Doctor | 01045317A | IN |
NPI | 1497782932 |
---|---|
Provider Name | Dr. Raymond Scott Nanko |
First Address | Fishers, IN 46038-0730 |
Second Address | Muncie, IN 47305-1554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 30/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200042680A | (05) | IN |
200149200A | (05) | IN |
G61644 | (02) | |
T18533 | (02) | IN |