MEDICARE: ROBERT EUGENE DILLON 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
1	1041C0700X	Clinical Social Worker	6801079595	MI

General Provider Information

NPI Number	:	1841426749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT EUGENE DILLON LMSW

Provider Business Mailing Address
First Line	:	22720 MICHIGAN AVE
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2035
Country	:	US
Telephone Number	:	313-274-3700
Fax Number	:	313-274-3767

Provider Business Practice Location Address
First Line	:	22720 MICHIGAN AVE
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2035
Country	:	US
Telephone Number	:	313-274-3700
Fax Number	:	313-274-3767

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	06/05/2009

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