| Dpn-mi PC | |
|
29877 Telegraph Rd Ste L-12 Southfield MI 48034-7657 | |
| (657) 439-4455 | |
| (248) 226-5827 |
| Full Name | Dpn-mi PC |
|---|---|
| Speciality | Clinic/center |
| Location | 29877 Telegraph Rd Ste L-12, Southfield, Michigan |
| Authorized Official Name and Position | Dominick Lago (OWNER) |
| Authorized Official Contact | 5303500889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dpn-mi PC 29877 Telegraph Rd Ste Ll-12 Southfield MI 48034-1332 Ph: (248) 213-6222 | Dpn-mi PC 29877 Telegraph Rd Ste L-12 Southfield MI 48034-7657 Ph: (657) 439-4455 |
| NPI Number | 1427623057 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 06/11/2021 |
| Certification Date | 06/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427623057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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