Provider Demographics
NPI:1447212956
Name:MIGITSCH, DOUGLAS CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CHARLES
Last Name:MIGITSCH
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 1:109 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:MOON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2513
Mailing Address - Country:US
Mailing Address - Phone:412-269-7220
Mailing Address - Fax:412-269-9972
Practice Address - Street 1:109 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:MOON TWP
Practice Address - State:PA
Practice Address - Zip Code:15108-2513
Practice Address - Country:US
Practice Address - Phone:412-269-7220
Practice Address - Fax:412-269-9972
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003279L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1398660Medicaid
PA1398660Medicaid
PAT30355Medicare UPIN