Individual
MARK E DIBBET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 LAKE ST, ROSCOMMON, MI 48653-9203
(989) 275-1200
(989) 275-1210
Mailing address
234 LAKE ST, ROSCOMMON, MI 48653-9203
(989) 275-1200
(989) 275-1210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301070153
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4624747
—
MI
05
—
4647170
—
MI
Enumeration date
07/14/2006
Last updated
11/23/2020
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