Individual
MR. DAVID HARLEY MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
14700 KING RD STE A, RIVERVIEW, MI 48193-7909
(734) 479-1944
Mailing address
14700 KING RD STE A, RIVERVIEW, MI 48193-7909
(734) 479-1944
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
4704236050
MI
363LF0000X
Family Nurse Practitioner
Primary
4704236050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704236050
MI LICENSE
MI
Enumeration date
08/29/2014
Last updated
01/08/2020
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