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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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 1134114895 NPPES
Other DM009144 BLUE CROSS BLUE SHIELD
MEDICAID 3361580 BLUE CROSS BLUE SHIELD

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