Individual provider Active NPI

Doina David, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Grand Blanc, MI
National Provider Identifier
1023058922
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301058735 Issued in MI
Practice address
9460 S Saginaw Rd Ste D
Grand Blanc, MI 48439-8207
Phone
(810) 733-7741
Fax
(810) 733-8898
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301058735 MI Primary

Addresses

Primary practice location

9460 S Saginaw Rd Ste D
Grand Blanc, MI 48439-8207

Mailing address

9460 S Saginaw Rd Ste D
Grand Blanc, MI 48439-8207
Phone (810) 733-7741

Other practice location 1

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3333

Other identifiers 1

IdentifierTypeStateIssuer
1023058922MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301058735MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Medical Group PLLC CurrentSince Jun 1, 2019 Accepting new patients
Envision Medical Group PLLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

17800 Newburgh Rd
Ste 103
Livonia, MI 48152
Phone (734) 464-9540

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1023058922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 S SAGINAW RD STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398207",
            "telephone_number": "810-733-7741",
            "fax_number": "810-733-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 S SAGINAW RD STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398207",
            "telephone_number": "810-733-7741",
            "fax_number": "810-733-8898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-3333",
            "fax_number": "313-966-4340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVID",
        "first_name": "DOINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301058735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023058922",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.