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NPI Code Detail

MEDICARE: DR. DENNIS L DISCH M.D.

MEDICARE: DR. DENNIS L DISCH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician104853MO
2207RC0000XCardiovascular Disease Physician4301115814MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003812926
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENNIS L DISCH M.D.
Provider Business Mailing Address
First Line : 61 N SAINT JOSEPH AVE
Second Line :
City : NILES
State : MI
Zip : 49120-2207
Country : US
Telephone Number : 269-684-6777
Fax Number : 269-683-5384
Provider Business Practice Location Address
First Line : 61 N SAINT JOSEPH AVE
Second Line :
City : NILES
State : MI
Zip : 49120-2207
Country : US
Telephone Number : 269-684-6777
Fax Number : 269-683-5384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 09/04/2018

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Directions to “ DR. DENNIS L DISCH M.D.” Practice Location

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