Provider Demographics
NPI:1811947823
Name:ACUS, DAVID L (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:ACUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5581 GALLERY PARK DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5055
Mailing Address - Country:US
Mailing Address - Phone:734-929-5881
Mailing Address - Fax:
Practice Address - Street 1:5581 GALLERY PARK DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5055
Practice Address - Country:US
Practice Address - Phone:734-929-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI005660207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4513381Medicaid
MI4513407Medicaid
MIDA005660OtherBC/BS
MIM60660250Medicare PIN
B46252Medicare UPIN