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Individual

DR. ANDREW I. DZUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
(586) 779-7610
Mailing address
21000 E 12 MILE RD, STE 111, ST CLAIR SHORES, MI 48081
(586) 779-7610
(586) 445-2523

Taxonomy

Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
AD044645
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040000850
RAILROAD MEDICARE
01
0405001172
BLUE CROSS BLUE SHIELD
MI
01
040E061920
BLUE SHIELD GROUP
MI
01
0500117
BLUE CARE NETWORK
01
101664
CARE CHOICES
01
103904
GREAT LAKES
01
2340163001
CIGNA
01
4033205
AETNA
01
A76344
HEALTH ALLIANCE PLAN
01
C4865
MCARE
Enumeration date
10/02/2006
Last updated
07/09/2012
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