Provider Demographics
NPI:1326147075
Name:TITUS, TODD MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:TITUS
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 1:43 STEEPLE RUN WAY
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1081
Mailing Address - Country:US
Mailing Address - Phone:910-704-8995
Mailing Address - Fax:912-920-0100
Practice Address - Street 1:8404 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3425
Practice Address - Country:US
Practice Address - Phone:912-920-8400
Practice Address - Fax:912-920-0100
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006779L111NS0005X
GACHIRO007991111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2718884OtherAETNA PIN
PA0000768617Medicare UPIN
PA0651504000Medicare UPIN
PA451503Medicare PIN
PA2718884OtherAETNA PIN