Healthcare Provider Details

I. General information

NPI: 1568491397
Provider Name (Legal Business Name): DAVID A HUFF DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 W M 21 STE 104
OVID MI
48866-9798
US

IV. Provider business mailing address

9900 W M 21 STE 104
OVID MI
48866-9798
US

V. Phone/Fax

Practice location:
  • Phone: 989-862-4224
  • Fax: 989-862-4382
Mailing address:
  • Phone: 989-862-4224
  • Fax: 989-862-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101009954
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: