Provider Demographics
NPI:1720164023
Name:BANNARD, DANIEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:BANNARD
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 1:915 KILDAIRE FARM RD
Mailing Address - Street 2:SUITE4
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3936
Mailing Address - Country:US
Mailing Address - Phone:919-461-8400
Mailing Address - Fax:
Practice Address - Street 1:915 KILDAIRE FARM RD
Practice Address - Street 2:SUITE4
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3936
Practice Address - Country:US
Practice Address - Phone:919-461-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC56214253001OtherCIGNA
NC10915274OtherCAQH CRADENTIALING PROVID
NC320254OtherACN
NC890823CMedicaid
NC0004532911OtherAETNA
NC0823COtherBLUE CROSS
NC562142530OtherHUMANA
NC441437OtherMAMSI
NC0194LOtherCNC
NC2454751OtherANTHEM
NC10915274OtherCAQH CRADENTIALING PROVID
NC320254OtherACN