Lewis-Bogan, Doresea L

Lewis-Bogan, Doresea L is an individual health care provider with primary practice located at 6309 Mack Ave , Detroit MI 48207-2302. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Lewis-Bogan, Doresea L can be contacted via phone (313) 331-3435.

Contact Information

Primary practice address
6309 Mack Ave Detroit MI 48207-2302
Phone: (313) 331-3435
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704241492 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 4704241492 Michigan

Profile Details

NPI number 1124218466
LBN Legal business name Lewis-Bogan, Doresea L
Credentials APRN,BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2007
Last updated Jan 18th, 2022 - about 3 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 1124218466 NPPES
Michigan MEDICAID 1124218466

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