Dea, Alice

Dea, Alice is an individual health care provider with primary practice located at 3990 John R St , Detroit MI 48201-2018. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Dea, Alice can be contacted via phone (313) 745-8040.

Contact Information

Primary practice address
3990 John R St Detroit MI 48201-2018
Phone: (313) 745-8040
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301048108 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4301048108 Michigan

Profile Details

NPI number 1073573366
LBN Legal business name Dea, Alice
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jun 18th, 2010 - about 14 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 1073573366 NPPES
Michigan Other AD048108 BC/BS OF MI
Michigan MEDICAID 101907266 BC/BS OF MI

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