Healthcare Provider Details

I. General information

NPI: 1770602104
Provider Name (Legal Business Name): DOREE ANN V. ESPIRITU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FORD PL BEHAVORIAL HEALTH SERVICES
DETROIT MI
48202-3450
US

IV. Provider business mailing address

1 FORD PL BEHAVORIAL HEALTH SERVICES
DETROIT MI
48202-3450
US

V. Phone/Fax

Practice location:
  • Phone: 313-874-4907
  • Fax:
Mailing address:
  • Phone: 313-874-4907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number4301066281
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301066281
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: