Booth, David G

Booth, David G is an individual health care provider with primary practice located at 3535 Park St Ste 110 , Norton Shores MI 49444-3736. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Booth, David G can be contacted via phone (231) 672-3155.

Contact Information

Primary practice address
3535 Park St Ste 110 Norton Shores MI 49444-3736
Fax: (231) 672-3157
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301046159 Michigan

Profile Details

NPI number 1154397404
LBN Legal business name Booth, David G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Mar 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154397404 NPPES
Michigan MEDICAID 4556191

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