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General NPI Number Information
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NPI Number | 1326219270
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Entity Type | Organization
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Legal Business Name | SIMPSON HOLZWORTH
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 14600 KING RD SUITE D
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City | RIVERVIEW
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State | MI
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Zip | 48193-7952
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Country | US
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Telephone | 734-479-7310
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Fax | 734-479-7307
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Provider Business Mailing Address
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Address Line | 14600 KING RD SUITE D
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City | RIVERVIEW
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State | MI
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Zip | 48193-7952
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Country | US
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Telephone | 734-479-7310
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Fax | 734-479-7307
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | DR. DAVID G HOLZWORTH
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Credential | DO
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Telephone | 734-479-7310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5101006598
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License Number State | MI
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