Healthcare Provider Details

I. General information

NPI: 1437142510
Provider Name (Legal Business Name): DAVID A INMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 IRVING AVE 9TH FL
SYRACUSE NY
13210-1687
US

IV. Provider business mailing address

4567 CROSSROADS PARK DR 2ND FL
LIVERPOOL NY
13088-3589
US

V. Phone/Fax

Practice location:
  • Phone: 315-470-7396
  • Fax: 315-470-2806
Mailing address:
  • Phone: 315-434-9309
  • Fax: 315-454-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number202495
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number202495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: