Provider Demographics
NPI:1346231032
Name:MCDANIEL, CLARE M (DC)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:M
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 HANALEI DR STE 3
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4303
Mailing Address - Country:US
Mailing Address - Phone:304-598-3000
Mailing Address - Fax:304-598-3025
Practice Address - Street 1:179 HANALEI DR STE 3
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4303
Practice Address - Country:US
Practice Address - Phone:304-598-3000
Practice Address - Fax:304-777-2429
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0132132000Medicaid
WV001705962OtherBLUE CROSS BLUE SHIELD
U12365Medicare UPIN
AT9353381Medicare ID - Type Unspecified