Charles David Dunavan, DPT, PT
Individual provider Active NPI Physical Therapist · Wixom, MI
NPI 1700710225 · NPPES record last updated Jun 10, 2026
Key facts
- NPI
- 1700710225
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501304574 (MI)
- Practice address
- 29822 S Wixom Rd
Wixom, MI 48393-3434 - Phone
- (248) 926-5826
- Fax
- (248) 926-5830
- NPI assigned
- Jun 10, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Plymouth Physical Therapy Specialists Limited Partnership
Practice addresses (Care Compare)
29822 S Wixom Rd
Wixom, MI 48393-3434
Phone (248) 926-5826
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260617001889 | MI | Practitioner - Physical Therapist in Private Practice | 7618449935 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501304574 | MI | Yes |
Addresses
Primary practice location
29822 S Wixom Rd
Wixom, MI 48393-3434
Mailing address
9368 N Lilley Rd
Plymouth, MI 48170-4610
Phone (248) 926-5826
Other providers in Wixom, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.