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NPI Code Detail

MEDICARE: DR. DARYL V COWAN D.C.

MEDICARE: DR. DARYL V COWAN D.C.
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
1111N00000XChiropractor08001542IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000214574OTHERINBLUE NUMBER BCBS
3351925531OTHERINFEDERAL TAX ID#

General Provider Information

NPI Number : 1821201070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARYL V COWAN D.C.
Provider Business Mailing Address
First Line : 1 PLAZA DR
Second Line : SUITE 20
City : PENDLETON
State : IN
Zip : 46064-8823
Country : US
Telephone Number : 765-778-7399
Fax Number : 765-778-7399
Provider Business Practice Location Address
First Line : 1 PLAZA DR
Second Line : SUITE 20
City : PENDLETON
State : IN
Zip : 46064-8823
Country : US
Telephone Number : 765-778-7399
Fax Number : 765-778-7399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 03/16/2016

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