| Peter C. Dodenhoff Do Pc | |
|
21811 Kelly Rd Suite 107 Eastpointe MI 48021-2793 | |
| (586) 773-0200 | |
| (586) 773-9803 |
| Full Name | Peter C. Dodenhoff Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 21811 Kelly Rd, Eastpointe, Michigan |
| Authorized Official Name and Position | Peter Dodenhoff (OWNER) |
| Authorized Official Contact | 5867730200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter C. Dodenhoff Do Pc 21811 Kelly Rd Suite 107 Eastpointe MI 48021-2793 Ph: (586) 773-0200 | Peter C. Dodenhoff Do Pc 21811 Kelly Rd Suite 107 Eastpointe MI 48021-2793 Ph: (586) 773-0200 |
| NPI Number | 1770754822 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770754822 | NPI | - | NPPES |
| 1174544928 | Medicaid | MI | |
| 0255012095 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PD006192 (Michigan) | Primary |
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