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NPI Code Detail

MEDICARE: ALISSA DIMICHELE D.O

MEDICARE: ALISSA DIMICHELE D.O
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
1207P00000XEmergency Medicine Physician5101024924MI

General Provider Information

NPI Number : 1235661703
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISSA DIMICHELE D.O
Provider Business Mailing Address
First Line : 15855 19 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3504
Country : US
Telephone Number : 586-263-2950
Fax Number :
Provider Business Practice Location Address
First Line : 15855 19 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3504
Country : US
Telephone Number : 586-263-2950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 04/13/2026

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Directions to “ ALISSA DIMICHELE D.O” Practice Location

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