Individual
MR. JUSTIN DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13850 E 12 MILE RD, WARREN, MI 48088-3730
(586) 552-4499
Mailing address
13850 E 12 MILE RD, WARREN, MI 48088-3730
(586) 552-4499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007803
MI
Other
Enumeration date
07/07/2016
Last updated
03/26/2024
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