Provider Demographics
NPI:1811594054
Name:HAUSMANN, DAVID MICHAEL
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:HAUSMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:OH
Mailing Address - Zip Code:45862-9722
Mailing Address - Country:US
Mailing Address - Phone:419-305-6779
Mailing Address - Fax:
Practice Address - Street 1:420 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:OH
Practice Address - Zip Code:45862-9722
Practice Address - Country:US
Practice Address - Phone:419-305-6779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care