Provider Demographics
NPI:1700802667
Name:JAMES, MICHAEL ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:JAMES
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 1:4310 AVONDALE LN NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1670
Mailing Address - Country:US
Mailing Address - Phone:330-479-9345
Mailing Address - Fax:888-892-8335
Practice Address - Street 1:4310 AVONDALE LN NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1670
Practice Address - Country:US
Practice Address - Phone:330-479-9345
Practice Address - Fax:888-892-8335
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3517111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2619465Medicaid
OH4146431Medicare ID - Type Unspecified