Healthcare Provider Details

I. General information

NPI: 1851442099
Provider Name (Legal Business Name): DAN E MCCANCE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 HUDSON RD
HILLSDALE MI
49242-8314
US

IV. Provider business mailing address

PO BOX 743
HILLSDALE MI
49242-0743
US

V. Phone/Fax

Practice location:
  • Phone: 517-439-0200
  • Fax: 517-439-1050
Mailing address:
  • Phone: 517-439-0200
  • Fax: 517-439-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number5101008347
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: