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NPI Code Detail

MEDICARE: DR. DOUGLAS A WINSTANLEY D.O.

MEDICARE: DR. DOUGLAS A WINSTANLEY D.O.
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
1207N00000XDermatology Physician5101015191MI
2207ND0101XMOHS-Micrographic Surgery Physician5101015191MI

General Provider Information

NPI Number : 1609855402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS A WINSTANLEY D.O.
Provider Business Mailing Address
First Line : 3434 RIVERTOWN POINT CT SW
Second Line :
City : GRANDVILLE
State : MI
Zip : 49418-3076
Country : US
Telephone Number : 616-257-3344
Fax Number : 616-257-1491
Provider Business Practice Location Address
First Line : 3434 RIVERTOWN POINT CT SW
Second Line :
City : GRANDVILLE
State : MI
Zip : 49418-3076
Country : US
Telephone Number : 616-257-3344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 07/30/2024

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