Provider Demographics
NPI:1497512636
Name:MCCLAIN, DANIEL WADE
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WADE
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 SHROYER RD APT 2
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3261
Mailing Address - Country:US
Mailing Address - Phone:757-775-3737
Mailing Address - Fax:
Practice Address - Street 1:1505 SHROYER RD APT 2
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45419-3261
Practice Address - Country:US
Practice Address - Phone:757-775-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker