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NPI Code Detail

MEDICARE: DAVID G PATTERSON DO PC

MEDICARE: DAVID G PATTERSON DO PC
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
1207Q00000XFamily Medicine Physician5101012588MI

General Provider Information

NPI Number : 1689867988
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID G PATTERSON DO PC
Provider Business Mailing Address
First Line : 25620 GIBRALTAR RD
Second Line :
City : FLAT ROCK
State : MI
Zip : 48134-1243
Country : US
Telephone Number : 734-789-9355
Fax Number :
Provider Business Practice Location Address
First Line : 25620 GIBRALTAR RD
Second Line :
City : FLAT ROCK
State : MI
Zip : 48134-1243
Country : US
Telephone Number : 734-789-9355
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DAVID PATTERSON
Credential : DO
Telephone Number : 734-789-9355
Provider Enumeration Date : 08/21/2007
Last Update Date : 03/28/2008

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