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General NPI Number Information
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NPI Number | 1790337210
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Entity Type | Individual
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Provider Name | DOROTHY DENISE BELL-RUTH
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Gender | Female
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 47601 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48374-1233
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Country | US
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Telephone | 248-849-3448
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Fax | 248-849-2729
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Provider Business Mailing Address
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Address Line | 18856 SOUTHAMPTON ST
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City | LIVONIA
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State | MI
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Zip | 48152-3050
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Country | US
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Telephone | 248-476-4049
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704217310
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License Number State | MI
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