Destine, Mike
Destine, Mike is an individual health care provider with primary practice located at 5401 Old Court Rd , Randallstown MD 21133-5103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Destine, Mike can be contacted via phone (914) 618-2312.Contact Information
Primary practice address
5401 Old Court Rd
Randallstown MD 21133-5103
Phone: (914) 618-2312
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X |
Profile Details
| NPI number | 1679995674 |
|---|---|
| LBN Legal business name | Destine, Mike |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2014 |
| Last updated | Jan 9th, 2014 - about 11 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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