Provider Demographics
NPI:1992859425
Name:DAVID D HODGE MD PC
Entity Type:Organization
Organization Name:DAVID D HODGE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-964-6061
Mailing Address - Street 1:44199 DEQUINDRE RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1128
Mailing Address - Country:US
Mailing Address - Phone:248-964-6061
Mailing Address - Fax:248-964-6054
Practice Address - Street 1:44199 DEQUINDRE RD
Practice Address - Street 2:SUITE 415
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1128
Practice Address - Country:US
Practice Address - Phone:248-964-6061
Practice Address - Fax:248-964-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301405955207V00000X
MI4301061638207V00000X
MI4301078155207V00000X
MI1467618694207V00000X
MI1265648711207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447367024OtherDR. SHELLEY SAPICK NPI
MI1477367024OtherDR STEENKEN INDIVIDUAL NP
MI1982644829OtherDR HODGE INDIVIDUAL NPI
1265648711OtherDR. ROSELYN DELA CRUZ NPI
1467618694OtherDR. MARY JORDAN NPI
MI1922039742OtherDR KWAISER INDIVIDUAL NPI