1992995799 NPI number — BRIAN J DALY MD PLC

Table of content: ARJUN CHENNA REDDY MD (NPI 1033371901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992995799 NPI number — BRIAN J DALY MD PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIAN J DALY MD PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992995799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 E MICHIGAN AVE
Provider Second Line Business Mailing Address:
STE 108
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49201-2457
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-788-9677
Provider Business Mailing Address Fax Number:
517-788-9118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W WASHINGTON AVE
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49201-2180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-788-9677
Provider Business Practice Location Address Fax Number:
517-841-1306
Provider Enumeration Date:
07/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DALY
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
517-788-9677

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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