Healthcare Provider Details

I. General information

NPI: 1447245584
Provider Name (Legal Business Name): DAVID A PARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

4841 MONROE ST SUITE 103
TOLEDO OH
43623-4385
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-4000
  • Fax:
Mailing address:
  • Phone: 419-474-4064
  • Fax: 419-472-2772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number35-058821
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35-058821
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: