Dudley, Daniel A
Dudley, Daniel A is an individual health care provider with primary practice located at 2904 Division St , Saint Joseph MI 49085-2437. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dudley, Daniel A can be contacted via phone (269) 983-2020.Contact Information
Primary practice address
2904 Division St
Saint Joseph MI 49085-2437
Phone: (269) 983-2020
Fax: (269) 983-3651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002802 | Michigan |
Profile Details
| NPI number | 1962539163 |
|---|---|
| LBN Legal business name | Dudley, Daniel A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jun 26th, 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 | 1962539163 | NPPES |
| Michigan | MEDICAID | 1785860 | |
| Michigan | Other | 900A165160 |
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