MEDICARE: DR. ANTONY JAMES DAROS DO

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
1	207Q00000X	Family Medicine Physician	5101013144	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003800350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTONY JAMES DAROS DO

Provider Business Mailing Address
First Line	:	8275 HOLLY RD
Second Line	:	STE 1
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-2442
Country	:	US
Telephone Number	:	810-603-0990
Fax Number	:	810-603-1678

Provider Business Practice Location Address
First Line	:	8275 HOLLY RD
Second Line	:	STE 1
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-2442
Country	:	US
Telephone Number	:	810-603-0990
Fax Number	:	810-603-1678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	06/05/2008

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