| David J Fugate Phd Pllc | |
|
1660 Haslett Rd Suite 1 Haslett MI 48840-8469 | |
| (517) 347-8420 | |
| Not Available |
| Full Name | David J Fugate Phd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1660 Haslett Rd, Haslett, Michigan |
| Authorized Official Name and Position | David James Fugate (LICENSED PSYCHOLOGIST OWNER) |
| Authorized Official Contact | 5173478420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J Fugate Phd Pllc 1660 Haslett Rd Suite 1 Haslett MI 48840-8469 Ph: (517) 347-8420 | David J Fugate Phd Pllc 1660 Haslett Rd Suite 1 Haslett MI 48840-8469 Ph: (517) 347-8420 |
| NPI Number | 1669511325 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3476548181 |
|---|---|
| Medicare Enrollment ID | O20040420000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669511325 | NPI | - | NPPES |
| 61-09431 | Other | MI | PHYSICIANS HEALTH PLAN MI |
| P77384 | Other | MI | VALUE OPTIONS BCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301006608 (Michigan) | Primary |
| Provider Name | David James Fugate |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326111261 PECOS PAC ID: 4688667918 Enrollment ID: I20040405000472 |
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