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NPI Code Detail

MEDICARE: DR. DAVID MICHAEL GARRISON M.D.

MEDICARE: DR. DAVID MICHAEL GARRISON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD059417LPA

General Provider Information

NPI Number : 1588635999
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID MICHAEL GARRISON M.D.
Provider Business Mailing Address
First Line : 111 E CATHERINE ST
Second Line :
City : MILFORD
State : PA
Zip : 18337-1347
Country : US
Telephone Number : 570-296-5792
Fax Number :
Provider Business Practice Location Address
First Line : 203 OLD MILITARY RD
Second Line :
City : LAKE PLACID
State : NY
Zip : 12946-1738
Country : US
Telephone Number : 518-523-1717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 03/09/2021

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