Dallas, William G

Dallas, William G is an individual health care provider with primary practice located at 1000 Harrington Blvd , Mount Clemens MI 48043. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Dallas, William G can be contacted via phone (586) 493-8747.

Contact Information

Primary practice address
1000 Harrington Blvd Mount Clemens MI 48043
Phone: (586) 493-8747
Fax: (586) 493-8741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704226096 Michigan

Profile Details

NPI number 1649365164
LBN Legal business name Dallas, William G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - 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 1649365164 NPPES
Michigan MEDICAID 4838500

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