Mazur, David
Mazur, David is an individual health care provider with primary practice located at 1055 Medical Park Dr Se , Grand Rapids MI 49546-3671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mazur, David can be contacted via phone (800) 968-6866.Contact Information
Primary practice address
1055 Medical Park Dr Se
Grand Rapids MI 49546-3671
Phone: (800) 968-6866
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 5101009144 | Michigan |
Profile Details
| NPI number | 1134114895 |
|---|---|
| LBN Legal business name | Mazur, David |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Sep 13th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134114895 | NPPES |
| Other | DM009144 | BLUE CROSS BLUE SHIELD | |
| MEDICAID | 3361580 | BLUE CROSS BLUE SHIELD |
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