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NPI Code Detail

MEDICARE: DR. DARYL G DAMRON D.C.

MEDICARE: DR. DARYL G DAMRON D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2301006527MI
2363A00000XPhysician Assistant5601003439MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OB55077OTHERMIBCBS ID
21002998OTHERMIMCLAREN HEALTH PLAN ID
3950B55077OTHERMIHEALTHPLUS ID
4P60609OTHERMIBCN ID
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6P00000552OTHERMITRAVELERS

General Provider Information

NPI Number : 1205803780
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARYL G DAMRON D.C.
Provider Business Mailing Address
First Line : 1345 WILLOWDALE CT B
Second Line :
City : FLINT
State : MI
Zip : 48532-4737
Country : US
Telephone Number : 810-820-6311
Fax Number :
Provider Business Practice Location Address
First Line : 102 N ADELAIDE ST
Second Line :
City : FENTON
State : MI
Zip : 48430-2670
Country : US
Telephone Number : 810-629-2245
Fax Number : 810-629-6535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 10/22/2015

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Directions to “ DR. DARYL G DAMRON D.C.” Practice Location

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