Healthcare Provider Details

I. General information

NPI: 1043298466
Provider Name (Legal Business Name): DAVID M MAGYAR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 OAKWOOD BLVD STE 109
DEARBORN MI
48124
US

IV. Provider business mailing address

PO BOX 673739
DETROIT MI
48267-3739
US

V. Phone/Fax

Practice location:
  • Phone: 313-299-6650
  • Fax: 313-299-6651
Mailing address:
  • Phone: 313-299-6650
  • Fax: 313-299-6651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number5101007496
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: