Individual
KARL MARTIN DOELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8098
(586) 493-8706
Mailing address
PO BOX 1108, ATTENTION: BARBRA SIMMONS, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101011989
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3155000384
BCBS INDIVIDUAL #
MI
05
—
4423785
—
MI
05
—
4458726
—
MI
Enumeration date
06/19/2006
Last updated
12/19/2007
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