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NPI Code Detail

MEDICARE: DR. DANIEL RAYMOND SCANGA M.D.

MEDICARE: DR. DANIEL RAYMOND SCANGA M.D.
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
12085R0202XDiagnostic Radiology Physician37728TN
22085R0202XDiagnostic Radiology Physician200500110NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689636185
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL RAYMOND SCANGA M.D.
Provider Business Mailing Address
First Line : PO BOX 221249
Second Line :
City : CHARLOTTE
State : NC
Zip : 28222-1249
Country : US
Telephone Number : 704-332-1291
Fax Number : 704-332-5206
Provider Business Practice Location Address
First Line : 3623 LATROBE DR STE 216
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-2117
Country : US
Telephone Number : 704-332-1291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 02/03/2023

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