Individual
DR. EDMOND J. DUCOMMUN
Active
Individual
DR. EDMOND J. DUCOMMUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301059003
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250331789
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
0M214400029
MEDICARE PLUS BLUE
MI
01
—
1010729
MCLAREN HEALTH PLAN-MEDICAID
MI
01
—
200000001909
PHP
MI
05
—
4541831
—
MI
01
—
4594007
AETNA
MI
05
—
4848089
—
MI
01
—
P00464732
RAILROAD MEDICARE
MI
Enumeration date
05/17/2006
Last updated
09/03/2019
Update your record
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