MEDICARE: DANIEL M MCNABB MD

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	207P00000X	Emergency Medicine Physician	47312	WI

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	:	1134238371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL M MCNABB MD

Provider Business Mailing Address
First Line	:	805 N 2ND ST
Second Line	:	APT 4
City	:	MEDFORD
State	:	WI
Zip	:	54451-1119
Country	:	US
Telephone Number	:	570-510-7227
Fax Number	:	843-497-6601

Provider Business Practice Location Address
First Line	:	CAROLINA HEALTH SPECIALISTS 4615 OLEANDER DR
Second Line	:	SUITE 201-A
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-1622
Country	:	US
Telephone Number	:	843-449-9559
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/07/2023

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