MEDICARE: STEVEN DYE JR.

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
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1184509697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN DYE JR.

Provider Business Mailing Address
First Line	:	6111 MARSEILLES ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48224-1325
Country	:	US
Telephone Number	:	313-285-0799
Fax Number	:

Provider Business Practice Location Address
First Line	:	19811 STOEPEL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-1745
Country	:	US
Telephone Number	:	313-494-7314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/28/2025

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Directions to “ STEVEN DYE JR. ” Practice Location

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