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Individual

MICHAEL V. OUIMETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-7808
Mailing address
2837 US 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301039723
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1600069
PHP
MI
05
2672870
MI
01
3003304611
BCBS MI INDIVIDUAL PIN
MI
01
310E210240
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
06/13/2006
Last updated
05/20/2008
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