Individual
DR. DAVID KOMASARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
28868 SALEM RD, FARMINGTON HILLS, MI 48334-3138
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101011074
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113377937
—
MI
05
—
114274961
—
MI
05
—
114287137
—
MI
05
—
114713696
—
MI
01
—
DK011074
BC/BS OF MICHIGAN
MI
Enumeration date
06/08/2006
Last updated
11/04/2014
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