Provider Demographics
NPI:1033567953
Name:DAVID, BRITTANY N (PA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:DAVID
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:N
Other - Last Name:STANEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2041 E SQUARE LAKE RD SUITE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085
Mailing Address - Country:US
Mailing Address - Phone:248-813-0124
Mailing Address - Fax:248-879-0148
Practice Address - Street 1:2041 E SQUARE LAKE RD SUITE 300
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:248-813-0124
Practice Address - Fax:248-879-0148
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant