Healthcare Provider Details

I. General information

NPI: 1336267301
Provider Name (Legal Business Name): DAVID F POMMERENING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 MIDDLEBELT RD
ROMULUS MI
48174-2039
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 915-778-4066
  • Fax: 615-778-9114
Mailing address:
  • Phone: 972-364-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301026996
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: