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NPI Code Detail

MEDICARE: DR. DAVID G PATTERSON D.O.

MEDICARE: DR. DAVID G PATTERSON D.O.
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

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 : 1881682821
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID G PATTERSON D.O.
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 : 734-789-1520
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 : 734-789-1520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 07/08/2007

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