MEDICARE: DAVID SENGSTOCK 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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	4301070113	MI

General Provider Information

NPI Number	:	1912987348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SENGSTOCK MD

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16351 ROTUNDA DR APT 168
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-2005
Country	:	US
Telephone Number	:	313-523-9781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	12/03/2024

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