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Individual

MR. JAMES ANTHONY DITARANTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2122 HEALTH DR SW, WYOMING, MI 49519-9698
(616) 252-6200
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-6200

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
114241
PA
363A00000X
Physician Assistant
Primary
5601007724
MI
363A00000X
Physician Assistant
MA056589
PA

Other

Enumeration date
11/22/2013
Last updated
10/11/2023
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