Organization
JOHN N DI BELLA MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN N DI BELLA MD (PRESIDENT)
(810) 659-7592
Entity
Organization
Contact information
Practice address
335 E HOUGHTON AVE, WEST BRANCH, MI 48661-1127
(989) 343-3124
(989) 343-3165
Mailing address
1451 CEDARWOOD DR, FLUSHING, MI 48433-1875
(810) 659-7592
(810) 659-7202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301062732
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0506500432
BLUE CROSS BLUE SHIELD
MI
05
—
411742210
—
MI
Enumeration date
06/11/2007
Last updated
01/30/2012
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