Dietzel, Douglas Paul

Dietzel, Douglas Paul is an individual health care provider with primary practice located at 4660 S Hagadorn Rd Suite 420, East Lansing MI 48823-5376. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Dietzel, Douglas Paul can be contacted via phone (517) 884-6100.

Contact Information

Primary practice address
4660 S Hagadorn Rd Suite 420 East Lansing MI 48823-5376
Phone: (517) 884-6100
Fax: (517) 884-6233
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 5101011314 Michigan

Profile Details

NPI number 1912934761
LBN Legal business name Dietzel, Douglas Paul
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Aug 22nd, 2016 - about 9 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 1912934761 NPPES
Michigan MEDICAID 3379305
Michigan MEDICAID 1912934761

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