Provider Demographics
NPI:1639476427
Name:MCPHARLIN, MICHAEL PATRICK (DC, BSN)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:MCPHARLIN
Suffix:
Gender:M
Credentials:DC, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 HURON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3763
Mailing Address - Country:US
Mailing Address - Phone:810-294-5678
Mailing Address - Fax:810-294-5677
Practice Address - Street 1:1025 HURON AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3763
Practice Address - Country:US
Practice Address - Phone:810-294-5678
Practice Address - Fax:810-294-5677
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOG40128OtherBCBS MICHIGAN
MI772167OtherUNITED HEALTHCARE - OPTUMHEALTH CARE SOLUTIONS
MI382040767OtherCOFINITY - AETNA
MIOG40128OtherBCBS MICHIGAN
MI382040767OtherCOFINITY - AETNA