Healthcare Provider Details

I. General information

NPI: 1003691742
Provider Name (Legal Business Name): DAVID NEWHOUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/30/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32E 1200 TELEGRAPH RD
PONTIAC MI
48341
US

IV. Provider business mailing address

32E 1200 TELEGRAPH RD
PONTIAC MI
48341
US

V. Phone/Fax

Practice location:
  • Phone: 800-231-1127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: