Provider Demographics
NPI:1750425682
Name:CALDER, DAVID MACDONELL (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MACDONELL
Last Name:CALDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2770 MAIN ST
Mailing Address - Street 2:PO BOX 307
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1141
Mailing Address - Country:US
Mailing Address - Phone:989-635-4000
Mailing Address - Fax:989-635-4056
Practice Address - Street 1:2770 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-1141
Practice Address - Country:US
Practice Address - Phone:989-635-4000
Practice Address - Fax:989-635-4056
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101016100OtherMICHIGAN STATE LICENSE NU
MI5315023950OtherCONTROLLED SUBSTANCE LICE
MIBC9857434OtherDEA NUMBER