Darren Allen Donathan, DC

Individual provider Active NPI Nutrition Chiropractor · Riverview, MI

NPI 1376563015 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1376563015
Entity type
Individual (NPI type 1)
Primary specialty
Nutrition Chiropractor 111NN1001X
License
2301008033 (MI)
Practice address
17533 Fort St
Riverview, MI 48193-6630
Phone
(734) 283-3200
Fax
(734) 283-5541
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2301008033MIMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Donathan Family Chiropractic PC Nutrition Past
since Dec 15, 2004
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 2301008033 MI Yes

Addresses

Primary practice location

17533 Fort St
Riverview, MI 48193-6630

Mailing address

17533 Fort St
Riverview, MI 48193-6630
Phone (734) 283-3200

Other identifiers

IdentifierTypeStateIssuer
4673859MedicaidMI

Other providers in Riverview, MI

All providers in Riverview, MI · Nutrition Chiropractor in Michigan

Sources for this page

Verify at the official NPI Registry.