Organization
DAVID J FUGATE PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JAMES FUGATE PHD (LICENSED PSYCHOLOGIST OWNER)
(517) 347-8420
Entity
Organization
Contact information
Practice address
1660 HASLETT RD, SUITE 1, HASLETT, MI 48840-8469
(517) 347-8420
Mailing address
1660 HASLETT RD, SUITE 1, HASLETT, MI 48840-8469
(517) 347-8420
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006608
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61-09431
PHYSICIANS HEALTH PLAN MI
MI
01
—
P77384
VALUE OPTIONS BCN
MI
Enumeration date
02/06/2007
Last updated
08/22/2020
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