Provider Demographics
NPI:1386646636
Name:AMALFITANO, DAVID J (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:AMALFITANO
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Gender:M
Credentials:DO
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Mailing Address - Street 1:4020 COPPER VW
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7098
Mailing Address - Country:US
Mailing Address - Phone:231-941-7500
Mailing Address - Fax:231-941-7509
Practice Address - Street 1:4020 COPPER VW
Practice Address - Street 2:SUITE 212
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7098
Practice Address - Country:US
Practice Address - Phone:231-941-7500
Practice Address - Fax:231-941-7509
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-12-07
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Provider Licenses
StateLicense IDTaxonomies
MI51010098612086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)