Provider Demographics
NPI:1548755044
Name:NEBBELING, DAVID JOHN (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:NEBBELING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 W COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9241
Mailing Address - Country:US
Mailing Address - Phone:517-525-8018
Mailing Address - Fax:
Practice Address - Street 1:790 E COLUMBIA ST STE 4
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1387
Practice Address - Country:US
Practice Address - Phone:517-525-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101025277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine