Kubek, Douglas Carl

Kubek, Douglas Carl is an individual health care provider with primary practice located at 21000 E 12 Mile Rd Ste 111, Saint Clair Shores MI 48081-1156. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Kubek, Douglas Carl can be contacted via phone (586) 779-7610.

Contact Information

Primary practice address
21000 E 12 Mile Rd Ste 111 Saint Clair Shores MI 48081-1156
Phone: (586) 779-7610
Fax: (586) 779-1391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 207YS0012X 5101012806 Michigan
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X 5101012806 Michigan

Profile Details

NPI number 1003903832
LBN Legal business name Kubek, Douglas Carl
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Mar 9th, 2021 - about 4 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 1003903832 NPPES
Michigan Other 0455010215 BCBSM
Michigan Other 14075 BCBSM
Michigan Other 040E061920 BCBSM
Michigan Other 133060 BCBSM
Michigan Other 104200 BCBSM
Michigan MEDICAID 4535235 BCBSM

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