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General NPI Number Information
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NPI Number | 1710058680
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Entity Type | Organization
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Legal Business Name | AMY J DAROS DO PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 5065 MILLER RD
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City | FLINT
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State | MI
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Zip | 48507-1037
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Country | US
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Telephone | 810-230-0338
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Fax | 810-230-0595
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Provider Business Mailing Address
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Address Line | PO BOX 887
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City | GRAND BLANC
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State | MI
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Zip | 48480-0887
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Country | US
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Telephone | 810-230-0338
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Fax | 810-230-0595
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | AMY J DAROS
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Credential | DO
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Telephone | 810-230-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 5101012998
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License Number State | MI
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