Provider Demographics
NPI:1508952474
Name:LOUIS, DAVID JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JONATHAN
Last Name:LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-1247
Mailing Address - Country:US
Mailing Address - Phone:937-369-1105
Mailing Address - Fax:
Practice Address - Street 1:44 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW BREMEN
Practice Address - State:OH
Practice Address - Zip Code:45869-1247
Practice Address - Country:US
Practice Address - Phone:937-369-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0600002083P0500X
NC2015-018852083P0500X
IN01069777A2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine