Provider Demographics
NPI:1730107905
Name:NEMASTIL, MICHAEL DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:NEMASTIL
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:SC HOUSE CALLS INC.
Mailing Address - Street 2:111 DOCTORS CIR
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:800-491-0909
Mailing Address - Fax:859-271-0050
Practice Address - Street 1:SC HOUSE CALLS INC.
Practice Address - Street 2:111 DOCTORS CIR
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:859-271-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4272111N00000X
SC4407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051336OtherANTHEM BLUE CROSS
KY04447OtherCHA
KY3065586OtherCIGNA
KY8585001576002Medicaid
KY440032OtherUNITED HEALTH CARE
KY607468OtherAMERICAN CHIROPRACTIC NET
KYU54796Medicare UPIN
KY8585001576002Medicaid