Provider Demographics
NPI:1194797308
Name:DURAN, DANIEL P (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:DURAN
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 1:302 DURAN DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-1986
Mailing Address - Country:US
Mailing Address - Phone:317-392-6200
Mailing Address - Fax:317-398-7526
Practice Address - Street 1:302 DURAN DR
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1986
Practice Address - Country:US
Practice Address - Phone:317-392-6200
Practice Address - Fax:317-398-7526
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100377380AMedicaid
U51417Medicare UPIN
IN742130Medicare ID - Type Unspecified