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Individual

DOUGLAS R. DEHAAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
27810 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5916
(248) 516-1978
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9600
(605) 328-9620

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1919
SD
207Q00000X
Family Medicine Physician
Primary
4301511075
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5607207
SD
Enumeration date
06/17/2005
Last updated
04/16/2024
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