Provider Demographics
NPI:1710077011
Name:MCARTHUR, EDWARD HAROLD (DC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:HAROLD
Last Name:MCARTHUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:TED
Other - Middle Name:
Other - Last Name:MCARTHUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:3380 MONROE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4726
Mailing Address - Country:US
Mailing Address - Phone:585-586-2120
Mailing Address - Fax:585-586-2650
Practice Address - Street 1:3380 MONROE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4726
Practice Address - Country:US
Practice Address - Phone:585-586-2120
Practice Address - Fax:585-586-2650
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0008262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
BB4807Medicare ID - Type Unspecified
U63503Medicare UPIN