Agnello-Dimitrijevic, Wilma

Agnello-Dimitrijevic, Wilma is an individual health care provider with primary practice located at 15855 19 Mile Rd , Clinton Twp MI 48038-3504. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Agnello-Dimitrijevic, Wilma can be contacted via phone (586) 263-2300.

Contact Information

Primary practice address
15855 19 Mile Rd Clinton Twp MI 48038-3504
Phone: (586) 263-2300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X WA058316 Michigan

Profile Details

NPI number 1104865443
LBN Legal business name Agnello-Dimitrijevic, Wilma
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Aug 1st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104865443 NPPES
Michigan MEDICAID 1104865443
Michigan MEDICAID 3290951

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