Provider Demographics
NPI:1336250299
Name:SCARBROUGH, DANIEL MCGEHEE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MCGEHEE
Last Name:SCARBROUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25819 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-3826
Mailing Address - Country:US
Mailing Address - Phone:251-981-0224
Mailing Address - Fax:251-981-0269
Practice Address - Street 1:25819 CANAL RD
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3826
Practice Address - Country:US
Practice Address - Phone:251-981-0224
Practice Address - Fax:251-981-0269
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72786Medicare UPIN