David J Van Dam CRNA

NPI 1033137153 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1033137153
Gender Male
Enumeration Date 07/17/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
11800 E 12 MILE RD
WARREN MI, 48093-3472, US
Phone (586) 573-5260
Fax (586) 573-5364
Business Location
11800 E 12 MILE RD
WARREN MI, 48093-3472, US
Phone (586) 573-5260
Fax (586) 573-5364
Toxanomy
Taxonomy Code 367500000X
License State Michigan
License Number 4704115131
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According to our database, David J Van Dam CRNA NPI is 1033137153, taxonomy code is 367500000X and license number is 4704115131, license state is located at Michigan. David J Van Dam CRNA physically located at 11800 E 12 Mile Rd, Warren MI, 48093-3472. NPI Number David J Van Dam CRNA has the Individual type.

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1033137153 NPI number is provided on an as is basis without warranty of any kind. 1033137153 is maintained by the National Plan & Provider Enumeration System. The contents of David J Van Dam CRNA are for informational purposes only.