Provider Demographics
NPI:1962534222
Name:MCAULIFFE, ARTHUR L III (DC)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:L
Last Name:MCAULIFFE
Suffix:III
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 1:9 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2911
Mailing Address - Country:US
Mailing Address - Phone:301-840-1113
Mailing Address - Fax:301-840-0979
Practice Address - Street 1:9 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2911
Practice Address - Country:US
Practice Address - Phone:301-840-1113
Practice Address - Fax:301-840-0979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01708111N00000X
MO006265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U52078Medicare UPIN
MDHC894340Medicare ID - Type Unspecified