Individual provider Active NPI

Daniel McIsaac, PHARMACIST

  • Pharmacist
  • Bloomfield Hills, MI
National Provider Identifier
1649794702
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302028284 Issued in MI
Practice address
2926 Courville Dr
Bloomfield Hills, MI 48302-1021
Phone
(248) 225-7206
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302028284 MI Primary

Addresses

Primary practice location

2926 Courville Dr
Bloomfield Hills, MI 48302-1021

Mailing address

2926 Courville Dr
Bloomfield Hills, MI 48302-1021
Phone (248) 225-7206

Other identifiers 1

IdentifierTypeStateIssuer
5302028284OtherMIMICHIGAN LARA

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302028284MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649794702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 COURVILLE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021021",
            "telephone_number": "248-225-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 COURVILLE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021021",
            "telephone_number": "248-225-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "DANIEL",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LARA",
            "identifier": "5302028284",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.