Individual
DR. DIANE PARSONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1105 SIXTH ST, ATTN: HOME CARE, TRAVERSE CITY, MI 49684-2349
(231) 935-6520
(231) 935-9116
Mailing address
1105 SIXTH ST, ATTN: HOME CARE, TRAVERSE CITY, MI 49684-2349
(231) 935-6520
(231) 935-9116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301405328
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0281046
BCBS#
MI
01
—
4301405328
STATE LICENSE #
MI
05
—
4618418
—
MI
01
—
P24420007
MEDICARE PART B - WPS
MI
Enumeration date
05/24/2005
Last updated
01/03/2013
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