David Pastoor, MD

Individual provider Active NPI Family Medicine Physician · Montague, MI

NPI 1194771824 · NPPES record last updated Jun 25, 2010

Key facts

NPI
1194771824
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
4301053688 (MI)
Practice address
4478 Dowling St
Montague, MI 49437-1201
Phone
(231) 894-4531
Fax
(231) 894-8158
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53688MIMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Michigan, Inc. Past Accepting new patients
McLaren Caro Region Past Accepting new patients
Lakeshore Emergency Solutions, PLLC Past Accepting new patients
Shelby Emergency Services, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301053688 MI Yes

Addresses

Primary practice location

4478 Dowling St
Montague, MI 49437-1201

Mailing address

5511 W US Highway 10
Ludington, MI 49431-2455
Phone (231) 843-1553

Other identifiers

IdentifierTypeStateIssuer
DP053688OtherMILICENSE
P00727292OtherRAIL ROAD MEDICARE
5409154MedicaidMI

Other providers in Montague, MI

All providers in Montague, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.