Organization
ALLERGY ASSOCIATES OF DEARBORN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE BERNICK (OFFICE MANAGER)
(313) 274-3311
Entity
Organization
Contact information
Practice address
751 S MILITARY ST, DEARBORN, MI 48124-2107
(313) 274-3311
(313) 274-3587
Mailing address
751 S MILITARY ST, DEARBORN, MI 48124-2107
(313) 274-3311
(313) 274-3587
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
JB047245
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02507830130
AMA
—
01
—
030001206
RAILROAD MEDICARE
MI
01
—
0822360
BCBS OF MI
MI
Enumeration date
10/16/2007
Last updated
10/16/2007
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