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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104865443 | NPPES |
| Michigan | MEDICAID | 1104865443 | |
| Michigan | MEDICAID | 3290951 |
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