DAVID MAZUR (NPI# 1134114895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134114895 |
| Entity Type | Individual |
| Full Name | DAVID MAZUR |
| Credential | DO |
| Practice Address |
1055 Medical Park Dr Se Grand Rapids MI 49546-3671 |
| Mailing Address |
Po Box 1969 Grand Rapids MI 49501-1969 |
| Practice Telephone | 8009686866 |
| Mailing Telephone | 8009686866 |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2010-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
5101009144 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | DM009144 | 01 | |
| MI | 3361580 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041609 | David Owen Mazur | Ophthalmology | National Naval Medical Ctr, 8901 Wisconsin Avenue, Bethesda, MD 20889-0001 | 2005-05-31 |
| 1801942362 | David R Mazur | Optometrist | 500 Davison Rd, Lockport, NY 14094 | 2007-01-26 |
| 1477579282 | David Timothy Mazur | Dentist | 1607 Saint James Ct, Tallahassee, FL 32308-5352 | 2006-07-14 |
| Street Address |
1055 MEDICAL PARK DR SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-3671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902808272 | Forest View Psychiatric Hospital Inc | Psychiatry & Neurology | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3671 | 2005-06-01 |
| 1649884214 | Jessy Gigowski | Counselor | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2020-09-01 |
| 1689207334 | Hill View Psychiatric Plc | Psychiatry & Neurology | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2020-02-20 |
| 1558900183 | Kathryn Long | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2019-12-30 |
| 1962050252 | Amelia Rose Grayson | Family Medicine | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-8323 | 2019-08-29 |
| 1841760972 | Kelly J Culmore | Psychiatry & Neurology | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2018-12-02 |
| 1710457858 | Jason Douglas Sikkema | Psychologist | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2018-12-02 |
| 1548752314 | Marci Marie Colyer | Registered Nurse | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2018-06-06 |
| 1447760640 | Jamie Marie Newman | Registered Nurse | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2017-10-03 |
| 1154861565 | Karli Reich | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2017-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1124462437 | Veritas Integrated Psychiatric Care, Pllc | Psychiatry & Neurology | 3265 Walker Ave Nw, Suite D, Grand Rapids, MI 49544-9708 | 2013-04-18 |
| 1982835526 | Mon C Poulose | Psychiatry & Neurology | 3225 N Evergreen Drive Ne, Suite 301, Grand Rapids, MI 49525 | 2009-07-30 |
| 1972652972 | Radosveta Stoyanov | Psychiatry & Neurology | 3225 N Evergreen Dr Ne, Grand Rapids, MI 49525-9334 | 2007-01-09 |
| 1679633994 | Philip C. Haines | Psychiatry & Neurology | 1011 Parchment Dr Se, Grand Rapids, MI 49546-3664 | 2006-12-08 |
| 1669546537 | Holly Ann Perkins | Psychiatry & Neurology | 2894 Thornapple River Dr Se, Grand Rapids, MI 49546-6857 | 2006-11-20 |
| 1801966122 | Theodore Fitch Mauger | Psychiatry & Neurology | 1325 Thornapple River Dr Se, Grand Rapids, MI 49546-9736 | 2006-11-08 |
| 1154407807 | Josharon Mutchler | Psychiatry & Neurology | 2035 28th St Se, Suite P, Grand Rapids, MI 49508 | 2006-10-27 |
| 1760581524 | Elmer William Fowler Jr. | Psychiatry & Neurology | 3351 Claystone St Se, Suite 212, Grand Rapids, MI 49546-5781 | 2006-09-21 |
| 1578676797 | Haith Place Inc | Psychiatry & Neurology | 2460 Burton St Se Ste 101, Grand Rapids, MI 49546-4806 | 2006-08-15 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on DAVID MAZUR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.