Healthcare Provider Details

I. General information

NPI: 1972413623
Provider Name (Legal Business Name): DAVID ROBERT GUZAK MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 NORTHFIELD PKWY
TROY MI
48098-4497
US

IV. Provider business mailing address

6445 AMBER LN
GRAND BLANC MI
48439-7835
US

V. Phone/Fax

Practice location:
  • Phone: 248-823-2878
  • Fax:
Mailing address:
  • Phone: 810-278-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801086402
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: