Individual
DR. MANUEL DUMLAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2314 MONROE ST, DEARBORN, MI 48124-3045
(313) 562-6633
(313) 562-0880
Mailing address
17655 COOLEY ST, DETROIT, MI 48219-2371
(313) 538-5244
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301047459
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2608218572
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/21/2006
Last updated
01/26/2010
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