Doctor Name: | MICHAEL RICHARD NAY |
NPI Number: | 1639306863 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 44040 |
Business Practice Address: | 5342 Dudley Blvd Mcclellan Air Force Satellite Clinic Mcclellan, CA - 956521012 |
Business Phone Number: | 9165617560 |
Business Fax Number: | 9165617566 |
Mailing Address: | 5342 Dudley Blvd, Mcclellan Air Force Satellite Clinic MCCLELLAN |
State: | CA |
Postal Code: | 956521012 |
Phone Number: | 9165617560 |
Fax Number: | 9165617566 |
NPI Enumeration Date: | 06/15/2009 |
NPI Last Update Date: | 01/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 44040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |