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NPI Code Detail

MEDICARE: DUSTIN FODO LMSW

MEDICARE: DUSTIN FODO LMSW
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 Worker6801121139MI

General Provider Information

NPI Number : 1821773375
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUSTIN FODO LMSW
Provider Business Mailing Address
First Line : 501 LAPEER AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48607-1203
Country : US
Telephone Number : 989-759-6464
Fax Number : 989-399-8233
Provider Business Practice Location Address
First Line : 690 S TRUMBULL ST
Second Line :
City : BAY CITY
State : MI
Zip : 48708-7692
Country : US
Telephone Number : 989-922-5700
Fax Number : 989-771-7050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2023
Last Update Date : 03/24/2026

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Directions to “ DUSTIN FODO LMSW” Practice Location

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