Healthcare Provider Details

I. General information

NPI: 1255723425
Provider Name (Legal Business Name): ASHLEY DOBSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

750 STEPHENSON HWY
TROY MI
48083-1103
US

V. Phone/Fax

Practice location:
  • Phone: 248-898-4021
  • Fax: 248-898-1473
Mailing address:
  • Phone: 248-577-4995
  • Fax: 248-577-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704261649
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: