=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891836243
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID S UNGAR DPM PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2007
-----------------------------------------------------
Last Update Date | 05/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34435 GRAND RIVER
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-477-3301
-----------------------------------------------------
Fax | 248-478-2829
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34435 GRAND RIVER
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-477-3301
-----------------------------------------------------
Fax | 248-478-2829
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DR PODIATRIST
-----------------------------------------------------
Name | DR. DAVID S UNGAR
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 248-477-3301
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | DU001140
-----------------------------------------------------
License Number State |
-----------------------------------------------------