Healthcare Provider Details

I. General information

NPI: 1235711706
Provider Name (Legal Business Name): DAVID POSTMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2021
Last Update Date: 04/24/2021
Certification Date: 04/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27483 DEQUINDRE RD STE 301
MADISON HEIGHTS MI
48071-5715
US

IV. Provider business mailing address

2221 76TH ST SW
BYRON CENTER MI
49315-8523
US

V. Phone/Fax

Practice location:
  • Phone: 248-546-2600
  • Fax: 248-546-2604
Mailing address:
  • Phone: 616-540-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: