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Individual

DEBRA MARY VAN ORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
8391 COMMERCE RD STE 103, COMMERCE TOWNSHIP, MI 48382-4489
(248) 690-6966
(248) 535-0226
Mailing address
8391 COMMERCE RD STE 103, COMMERCE TOWNSHIP, MI 48382-4489
(248) 690-6966
(248) 653-5022

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DV009592
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0156308105
BCBS
MI
01
MI12421
MEDICARE
MI
Enumeration date
01/12/2007
Last updated
09/10/2020
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