Provider Demographics
NPI:1871709162
Name:DAVID L HAROLD M.D.,P.C.
Entity type:Organization
Organization Name:DAVID L HAROLD M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:HAROLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-335-6700
Mailing Address - Street 1:44555 WOODWARD AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5031
Mailing Address - Country:US
Mailing Address - Phone:248-335-6700
Mailing Address - Fax:248-858-3894
Practice Address - Street 1:44555 WOODWARD AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5031
Practice Address - Country:US
Practice Address - Phone:248-335-6700
Practice Address - Fax:248-858-3894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI032177174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P57090Medicare PIN