Provider Demographics
NPI:1306878269
Name:WARTINGER, DAVID DON (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DON
Last Name:WARTINGER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:B405 WEST FEE HALL
Mailing Address - Street 2:DEPART OF OSTEOPATHIC SURGICAL SPECIALTIES
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-1315
Mailing Address - Country:US
Mailing Address - Phone:517-353-8470
Mailing Address - Fax:
Practice Address - Street 1:2900 HANNAH BLVD
Practice Address - Street 2:STE 215
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5384
Practice Address - Country:US
Practice Address - Phone:517-364-8118
Practice Address - Fax:517-364-8119
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101011513208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4088240Medicaid
MI4088240Medicaid
MI0C36082037Medicare PIN