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General NPI Number Information
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NPI Number | 1912051293
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Entity Type | Organization
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Legal Business Name | DELTA-MENOMINEE DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2920 COLLEGE AVE
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City | ESCANABA
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State | MI
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Zip | 49829-9597
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Country | US
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Telephone | 906-786-4111
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Fax | 906-786-7004
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Provider Business Mailing Address
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Address Line | 2920 COLLEGE AVE
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City | ESCANABA
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State | MI
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Zip | 49829-9597
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Country | US
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Telephone | 906-786-4111
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Fax | 906-786-7004
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Authorized Official
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Title or Position | HEALTH OFFICER & MEDICAL DIRECTOR
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Name | DR. JOHN R PETRASKY
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Credential | MD
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Telephone | 906-789-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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