Individual
KORY V. DEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
321 E HARRIS ST, CHARLOTTE, MI 48813-1629
(517) 543-1050
(517) 543-0875
Mailing address
321 E HARRIS ST, CHARLOTTE, MI 48813-1629
(517) 543-1050
(517) 543-0875
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301044811
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101558254
—
MI
01
—
3900122
PHYSICIANS HEALTH PLAN
MI
01
—
3970122
PHP FAMILY CARE
MI
01
—
KD044811
BCBS
MI
01
—
P105859
BLUE CARE NETWORK
MI
Enumeration date
06/04/2006
Last updated
07/08/2007
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