David Leon Dora, D.O.
Individual provider Active NPI Family Medicine Physician · Fruitport, MI
NPI 1629079686 · NPPES record last updated Jan 18, 2013
Key facts
- NPI
- 1629079686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101007779 (MI)
- Practice address
- 3443 Farr Rd
Fruitport, MI 49415-8779 - Phone
- (231) 672-2900
- Fax
- (231) 672-2901
- NPI assigned
- Aug 2, 2005
- 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)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101007779 | MI | Yes |
Addresses
Primary practice location
3443 Farr Rd
Fruitport, MI 49415-8779
Mailing address
PO Box 1848
Muskegon, MI 49443-1848
Phone (231) 727-4444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2590390 | Medicaid | MI | |
| 112590390 | Other | MI | MUSKEGON CARE/ACCESS HEAL |
| 101635 | Other | MI | PREFERRED CHOICE |
| 102 | Other | MI | COMMUNITY CHOICE |
| 18799 | Other | MI | HEALTH PLAN OF MICHIGAN |
Other names
- Dr. David Leon Dora
Other providers in Fruitport, MI
- Country-Side Counseling & Consultation Services, PC
- Delphia Croff
- Allison Nichole Crowl
- Nathan Dills
- Donna L Rick DDS PC
- Susan Kay Ercia
- Amanda Marie Faino
- Fruitport Family Eye Care, PLLC
- Caitlin E Fulton
- Erika Glatz
All providers in Fruitport, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.