MEDICARE: DR. VINCENT DAVID DINICK M.D.,D.M.D.

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	208200000X	Plastic Surgery Physician	4301076963	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871591883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT DAVID DINICK M.D.,D.M.D.

Provider Business Mailing Address
First Line	:	200 ARNET ST
Second Line	:	STE. 180
City	:	YPSILANTI
State	:	MI
Zip	:	48198-5753
Country	:	US
Telephone Number	:	248-919-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ARNET ST
Second Line	:	STE. 180
City	:	YPSILANTI
State	:	MI
Zip	:	48198-5753
Country	:	US
Telephone Number	:	248-919-1100
Fax Number	:

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	04/14/2021

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