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Organization
JOHN D. DINGELL VA MEDICAL CENTER
Active
Organization
JOHN D. DINGELL VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ANTOINETTE HICKS LPN (TELEHEALTH COORDINATOR)
(313) 576-1000
Entity
Organization
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
NULL
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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