Organization
DIGESTIVE DISEASE CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY METHENY RN (OFFICE MANAGER)
(248) 858-3878
Entity
Organization
Contact information
Practice address
44555 WOODWARD AVE, SUITE 304, PONTIAC, MI 48341-5031
(248) 858-3878
(248) 209-6777
Mailing address
44555 WOODWARD AVE, SUITE 304, PONTIAC, MI 48341-5031
(248) 858-3878
(248) 209-6777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100F316670
BLUE CROSS BLUE SHEILD
MI
Enumeration date
01/16/2007
Last updated
09/15/2021
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