Healthcare Provider Details

I. General information

NPI: 1184820979
Provider Name (Legal Business Name): DAVID CRITTENDEN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E CASS ST
GREENVILLE MI
48838-1584
US

IV. Provider business mailing address

123 E CASS ST
GREENVILLE MI
48838
US

V. Phone/Fax

Practice location:
  • Phone: 616-225-8707
  • Fax: 616-225-8967
Mailing address:
  • Phone: 616-225-8707
  • Fax: 616-225-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID B CRITTENDEN
Title or Position: OWNER
Credential: M.D.
Phone: 616-225-8707