David Garrison, M.D.

Individual provider Active NPI Family Medicine Physician · University Park, PA

NPI 1053439463 · NPPES record last updated Jul 15, 2008

Key facts

NPI
1053439463
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD-032906-E (PA)
Practice address
449 Student Health Center
University Park, PA 16802
Phone
(814) 863-8871
Fax
(814) 863-8464
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-032906-EPAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-032906-E PA Yes

Addresses

Primary practice location

449 Student Health Center
University Park, PA 16802

Mailing address

449 Student Health Center
University Park, PA 16802
Phone (814) 863-8871

Other identifiers

IdentifierTypeStateIssuer
GA514782OtherPABLUE SHIELD

Other providers in University Park, PA

All providers in University Park, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.