Provider Demographics
NPI:1891724787
Name:GUZZARDO, DAVID A (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:GUZZARDO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39725 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-2799
Mailing Address - Country:US
Mailing Address - Phone:586-286-6616
Mailing Address - Fax:586-286-5194
Practice Address - Street 1:39725 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-2799
Practice Address - Country:US
Practice Address - Phone:586-286-6616
Practice Address - Fax:586-286-5194
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301300311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E02305OtherBLUE CARE NETWORK OF MI
MI0E02305OtherBLUE CROSS OF MI
MI144316471Medicaid
MI1487783569Medicare PIN
MI144316471Medicaid