Provider Demographics
NPI:1952453953
Name:COCKS, DANIEL T (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:COCKS
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 1:9309 BELAIR RD
Mailing Address - Street 2:STE C
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1605
Mailing Address - Country:US
Mailing Address - Phone:410-686-4660
Mailing Address - Fax:410-686-4661
Practice Address - Street 1:9707 PULASKI HWY STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-1407
Practice Address - Country:US
Practice Address - Phone:410-686-4660
Practice Address - Fax:410-686-4661
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD141264ZCAUOtherMEDICARE GROUP MEMBER PROVIDER NUMBER
MDK120OtherBLUE CHOICE
MD352BDAOtherBLUE CROSS
MDK120OtherBLUE CHOICE
MD141264ZCAUOtherMEDICARE GROUP MEMBER PROVIDER NUMBER