Healthcare Provider Details

I. General information

NPI: 1619122157
Provider Name (Legal Business Name): DENNIS VEAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 KERCHEVAL
DETROIT MI
48214-2968
US

IV. Provider business mailing address

7900 KERCHEVAL
DETROIT MI
48214-2968
US

V. Phone/Fax

Practice location:
  • Phone: 313-924-9798
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number23816
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: