Organization
IRA ZACHARY DYME MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRA ZACHARY DYME MD (OWNER)
(517) 482-1111
Entity
Organization
Contact information
Practice address
2909 E GRAND RIV, SUITE 108, LANSING, MI 48912-4300
(517) 482-1111
(517) 482-1119
Mailing address
2909 E GRAND RIV, SUITE 108, LANSING, MI 48912-4300
(517) 482-1111
(517) 482-1119
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
4301046743
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101559420
—
MI
01
—
3503311161
BCBS OF MICHIGAN
MI
Enumeration date
11/10/2006
Last updated
07/14/2008
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