Provider Information for 1265977128
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
MICHAEL DUBOSE
Sex: Male
NPI: 1265977128
Last Updated: 2017-01-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265977128 | ||||||||||||
| Enumeration Date | 2017-01-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 5725 NEWBERRY DR APT 201 STERLING HEIGHTS, MI 48310-7434 United States Phone: 313-918-8304 | Fax: | ||||||||||||
| Primary Practice Address | 5725 NEWBERRY DR APT 201 STERLING HEIGHTS, MI 48310-7434 United States Phone: 313-918-8304 | Fax: | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|