MEDICARE: DR. DARRELL SCS MISAK N.D., RPH

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	175F00000X	Naturopath	1080	OR

General Provider Information

NPI Number	:	1578727145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRELL SCS MISAK N.D., RPH

Provider Business Mailing Address
First Line	:	20 CEDAR BLVD
Second Line	:	SUITE 303
City	:	MT LEBANON
State	:	PA
Zip	:	15228-1330
Country	:	US
Telephone Number	:	412-563-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 CEDAR BLVD
Second Line	:	SUITE 303
City	:	MT LEBANON
State	:	PA
Zip	:	15228-1330
Country	:	US
Telephone Number	:	412-563-1600
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	07/14/2008

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