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General NPI Number Information
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NPI Number | 1700402492
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Entity Type | Individual
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Provider Name | JOSEPH DUBE DO
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Gender | Male
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 1375 N MAIN ST
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City | LAPEER
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State | MI
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Zip | 48446-1350
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Country | US
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Telephone | 810-667-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 503 BLOOMFIELD BLVD
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City | JACKSON
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State | MI
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Zip | 49203-4057
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Country | US
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Telephone | 734-578-2421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101027794
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License Number State | MI
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