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NPI Code Detail

MEDICARE: DAVID BRUCE MACDOUGALL MD

MEDICARE: DAVID BRUCE MACDOUGALL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician4301042793MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659376416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BRUCE MACDOUGALL MD
Provider Business Mailing Address
First Line : 224 CIRCLE DR
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2342
Country : US
Telephone Number : 231-932-4855
Fax Number : 231-932-4850
Provider Business Practice Location Address
First Line : 224 CIRCLE DR
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2342
Country : US
Telephone Number : 231-932-4855
Fax Number : 231-932-4850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 02/24/2021

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Directions to “ DAVID BRUCE MACDOUGALL MD” Practice Location

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