Individual
DR. DAVID TODD WALSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
804 SERVICE RD STE A225, EAST LANSING, MI 48824-7015
(517) 353-2562
(517) 353-2563
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 353-2562
(517) 353-2563
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301062319
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346276144
—
MI
05
—
4720304
—
MI
Enumeration date
06/23/2006
Last updated
06/29/2023
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