Provider Demographics
NPI:1184643025
Name:PATRICK, DAVID A (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:PATRICK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3264 N EVERGREEN DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9746
Mailing Address - Country:US
Mailing Address - Phone:616-363-7272
Mailing Address - Fax:616-363-7290
Practice Address - Street 1:4660 S HAGADORN RD STE 410
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6819
Practice Address - Country:US
Practice Address - Phone:517-353-5053
Practice Address - Fax:517-884-6236
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-22
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Provider Licenses
StateLicense IDTaxonomies
MI51010113432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology