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NPI Code Detail

MEDICARE: DYLAN PAYNE

MEDICARE: DYLAN PAYNE
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1093446031
Entity Type Code : Individual
Provider Name (Legal Business Name) : DYLAN PAYNE
Provider Business Mailing Address
First Line : 6500 N INKSTER RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1807
Country : US
Telephone Number : 616-301-8000
Fax Number :
Provider Business Practice Location Address
First Line : 6500 N INKSTER RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1807
Country : US
Telephone Number : 616-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2022
Last Update Date : 08/09/2022

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Directions to “ DYLAN PAYNE ” Practice Location

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