Individual
DR. DAVID WILLIAM TESAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
583 S CLARIZZ BLVD, BLOOMINGTON, IN 47401-5515
(812) 676-4460
(812) 355-4092
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01064317A
IN
2084N0400X
Neurology Physician
35066615
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540871
MEDICARE PTAN
IN
Enumeration date
11/01/2006
Last updated
06/28/2023
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