Individual
DOUGLAS HOMNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3299 GULL RD, KALAMAZOO, MI 49048-1281
(269) 373-5259
(269) 373-5292
Mailing address
3299 GULL RD, KALAMAZOO, MI 49048-1281
(269) 373-5259
(269) 373-5292
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
4301049780
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942279815
—
MI
01
—
3513924451
BCBS
—
05
—
4200108
—
MI
Enumeration date
03/14/2006
Last updated
08/04/2016
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