Individual
DOMINIQUE DELCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21777 21 MILE RD, MACOMB, MI 48044-2962
(586) 949-2078
Mailing address
21777 21 MILE RD, MACOMB, MI 48044-2962
(586) 949-2078
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704234638
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700359957
—
MI
Enumeration date
01/09/2019
Last updated
08/23/2021
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