Individual
MR. SAMUEL G DYSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
601 BRIDGE ST, EAST JORDAN, MI 49727-9383
(231) 536-2206
(231) 536-9864
Mailing address
601 BRIDGE ST, EAST JORDAN, MI 49727-9383
(231) 536-2206
(231) 536-9864
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005079
MI
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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