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DAVID NELSON VIGOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
350 N CENTER ST, LOWELL, MI 49331-1212
(616) 897-8473
(616) 897-0081
Mailing address
5938 BUTTONWOOD DR, HASLETT, MI 48840-9757
(517) 339-6405
(517) 339-6405

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301051646
MI
2084P0802X
Addiction Psychiatry Physician
Primary
4301051646
MI
2084P0805X
Geriatric Psychiatry Physician
4301051646
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0330457
BLUE CROSS/BLUE SHIELD
MI
01
4301051646
STATE OF MICHIGAN LICENSE
MI
01
P00092490
RAILROAD MEDICARE
MI
Enumeration date
07/30/2006
Last updated
09/11/2025
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