David Jon Blystra
Family Medicine in Holland, MI. Individual provider (NPI-1).
NPI number1508328014
StatusActive
Last updated in NPPESAug 9, 2022
Details
- NPI
- 1508328014
- Entity type
- Individual (NPI-1)
- Name
- David Jon Blystra
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2019
- Certification date
- Aug 9, 2022
- Last updated
- Aug 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 4301506520 | MI | Yes |
| 207Q00000X | Family Medicine | 9999999 | AZ |
Practice location
904 Washington Ave Ste 210Holland, MI 49423-7724
Phone 616-392-8035
Mailing address
904 Washington Ave Ste 210Holland, MI 49423-7724
Phone 616-392-8035
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All 61 Family Medicine Physician providers in Holland · All 2,693 providers in Holland
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