Provider Demographics
NPI:1154380087
Name:DANUBIO, RICHARD MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:DANUBIO
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 1:474 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1385
Mailing Address - Country:US
Mailing Address - Phone:978-536-3111
Mailing Address - Fax:978-536-7477
Practice Address - Street 1:474 LOWELL ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1385
Practice Address - Country:US
Practice Address - Phone:978-536-3111
Practice Address - Fax:978-536-7477
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA629111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35420Medicare ID - Type Unspecified