Provider Demographics
NPI:1073548038
Name:PARKER, DAVID B (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 S M 37 HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-9676
Mailing Address - Country:US
Mailing Address - Phone:269-948-0078
Mailing Address - Fax:269-948-0099
Practice Address - Street 1:225 S M 37 HWY STE 1
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-9676
Practice Address - Country:US
Practice Address - Phone:269-948-0078
Practice Address - Fax:269-948-0099
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301075340207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0600810122OtherBCBSM
MI20452OtherHEALTH PLAN OF MICHIGAN
MI4576434Medicaid
MI4576434Medicaid
MI0600810122OtherBCBSM