Organization
PAUL N DEWEESE MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL N DEWEESE M.D. (DOCTOR)
(517) 339-3200
Entity
Organization
Contact information
Practice address
1650 HASLETT RD, SUITE 1, HASLETT, MI 48840-8438
(517) 339-3200
Mailing address
1650 HASLETT RD, SUITE 1, HASLETT, MI 48840-8438
(517) 339-3200
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
PD044882
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104833729
—
MI
01
—
1102310191
BCBS
MI
01
—
200000001879
PHP
MI
Enumeration date
10/19/2007
Last updated
10/19/2007
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