MEDICARE: PAUL DUGLISS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	4301063616	MI

General Provider Information

NPI Number	:	1194938886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL DUGLISS M.D.

Provider Business Mailing Address
First Line	:	2035 HOGBACK RD
Second Line	:	SUITE 211
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9732
Country	:	US
Telephone Number	:	734-786-1653
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 HOGBACK RD
Second Line	:	SUITE 211
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9732
Country	:	US
Telephone Number	:	734-786-1653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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