Individual
DR. DAERYL DAVE ELGINCOLIN AMPONIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18341 US HIGHWAY 41, LANSE, MI 49946-8024
(906) 524-3300
Mailing address
18341 US HIGHWAY 41, LANSE, MI 49946-8024
(906) 524-3300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4351050910
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2023
Last updated
06/30/2026
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