Provider Demographics
NPI:1811181118
Name:KRIZMAN, DAVID JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:KRIZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 N MICHIGAN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-1760
Mailing Address - Country:US
Mailing Address - Phone:574-935-4000
Mailing Address - Fax:574-941-4408
Practice Address - Street 1:322 N MICHIGAN ST
Practice Address - Street 2:SUITE E
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1760
Practice Address - Country:US
Practice Address - Phone:574-935-4000
Practice Address - Fax:574-941-4408
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01021038A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice