Provider Demographics
NPI:1548369010
Name:MCGREGOR, DANIEL MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARTIN
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 W HOUGHTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PRUDENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48651-9701
Mailing Address - Country:US
Mailing Address - Phone:989-366-4646
Mailing Address - Fax:989-366-4647
Practice Address - Street 1:1223 W HOUGHTON LAKE DR
Practice Address - Street 2:
Practice Address - City:PRUDENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48651-9701
Practice Address - Country:US
Practice Address - Phone:989-366-4646
Practice Address - Fax:989-366-4647
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDM005551111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950G210180OtherBLUE CROSS AND BLUE SHIEL
MIOP27390Medicare ID - Type UnspecifiedGROUP NUMBER