Provider Demographics
NPI:1932341583
Name:SVOBODA, TODD W
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:W
Last Name:SVOBODA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3562 S LAPEER RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-8767
Mailing Address - Country:US
Mailing Address - Phone:810-678-8100
Mailing Address - Fax:810-678-8102
Practice Address - Street 1:3562 S LAPEER RD
Practice Address - Street 2:SUITE E
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8767
Practice Address - Country:US
Practice Address - Phone:810-678-8100
Practice Address - Fax:810-678-8102
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies