Provider Demographics
NPI:1841344249
Name:MCCAINE, FATIHA K (DC)
Entity type:Individual
Prefix:DR
First Name:FATIHA
Middle Name:K
Last Name:MCCAINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4231 N SAINT PETERS PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7384
Mailing Address - Country:US
Mailing Address - Phone:636-928-0311
Mailing Address - Fax:636-634-3485
Practice Address - Street 1:4231 NORTH SAINT PETERS PARKWAY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63304-8579
Practice Address - Country:US
Practice Address - Phone:636-928-0311
Practice Address - Fax:636-928-8670
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007007487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260425249OtherMEDICARE