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Organization
WILLARD P DEBRABER DO PC
Active
Organization
WILLARD P DEBRABER DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLARD PETER DEBRABER D.O. (PRESIDENT)
(231) 773-3228
Entity
Organization
Contact information
Practice address
1761 WELLS AVE, MUSKEGON, MI 49442-2459
(231) 773-3228
(231) 773-3482
Mailing address
1761 WELLS AVE, MUSKEGON, MI 49442-2459
(231) 773-3228
(231) 773-3482
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5101006662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255334397
TYPE I NPI
MI
05
—
2101067
—
MI
01
—
5611044
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/17/2010
Last updated
05/18/2015
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