Individual
DR. DANIEL E PANUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28625 NORTHWESTERN HWY, SUITE 213, SOUTHFIELD, MI 48034-1828
(248) 354-9666
(248) 354-3653
Mailing address
32255 NORTHWESTERN HWY, STE 130, FARMINGTON HILLS, MI 48334-1505
(248) 354-9666
(248) 354-3653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301035149
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0636952
BCBS INDIVIDUAL
MI
01
—
102416
GREAT LAKES HEALTH PLAN
MI
01
—
110169408
RR MEDICARE
MI
05
—
1669457909
—
MI
01
—
700F314390
BLUE SHIELD
MI
01
—
B0281
M'CARE
MI
Enumeration date
12/09/2005
Last updated
09/14/2018
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