Provider Demographics
NPI:1538184551
Name:MAY, DAVID BLAKE (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BLAKE
Last Name:MAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:ACME
Mailing Address - State:MI
Mailing Address - Zip Code:49610-0363
Mailing Address - Country:US
Mailing Address - Phone:231-938-7968
Mailing Address - Fax:231-346-6044
Practice Address - Street 1:6100 US HIGHWAY 31 N
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690-9306
Practice Address - Country:US
Practice Address - Phone:231-938-7968
Practice Address - Fax:231-346-6044
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIDM013379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0852810264OtherBLUE CROSS BLUE SHIELD
MI28346OtherPRIORITY HEALTH
MI4834978Medicaid
MIG85845Medicare UPIN
MI4834978Medicaid