Provider Demographics
NPI:1952314361
Name:HARKER, MICHAEL SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOTT
Last Name:HARKER
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 1:4770 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2021
Mailing Address - Country:US
Mailing Address - Phone:937-433-5154
Mailing Address - Fax:937-433-2884
Practice Address - Street 1:4770 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-2021
Practice Address - Country:US
Practice Address - Phone:937-433-5154
Practice Address - Fax:937-433-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000364431OtherANTHEM
OH0460040Medicaid
OH4490200OtherUNITED HEALTHCARE
OH0768932Medicare PIN
OH000000364431OtherANTHEM