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NPI Code Detail

MEDICARE: DR. DENNIS VINCENT DESIMONE DO

MEDICARE: DR. DENNIS VINCENT DESIMONE DO
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
1207R00000XInternal Medicine Physician5101007912MI
2208M00000XHospitalist Physician5101007912MI

General Provider Information

NPI Number : 1467468934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENNIS VINCENT DESIMONE DO
Provider Business Mailing Address
First Line : 1150 E SHERMAN BLVD STE 1100
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-4607
Country : US
Telephone Number : 231-672-7800
Fax Number : 231-672-7801
Provider Business Practice Location Address
First Line : 1150 E SHERMAN BLVD STE 1100
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-4607
Country : US
Telephone Number : 231-672-7800
Fax Number : 231-672-7801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/24/2024

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