Individual
JUSTIN DANIEL DONOGHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
71 HUGHEY ST, MUSKEGON, MI 49445-2115
(989) 280-3799
Mailing address
71 HUGHEY ST, MUSKEGON, MI 49445-2115
(989) 280-3799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704313630
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704313630
—
MI
Enumeration date
08/13/2020
Last updated
08/13/2020
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