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NPI Code Detail

MEDICARE: MRS. ADRIENNE L DILLARD BA, BS, MBA

MEDICARE: MRS. ADRIENNE L DILLARD BA, BS, MBA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1306087564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADRIENNE L DILLARD BA, BS, MBA
Provider Business Mailing Address
First Line : 19750 BURT RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-2078
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19750 BURT RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-2078
Country : US
Telephone Number : 313-977-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 08/12/2022

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