Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | DK058272 | MI |
NPI | 1427013184 |
---|---|
Provider Name | Duane E Kreil |
First Address | W Bloomfield, MI 48322-3379 |
Second Address | Dearborn, MI 48124-2353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 13/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015098 | MIDWEST HEALTH PLANS (01) | MI |
125116 | CARE CHOICES (01) | MI |
160H261380 | BCBSM/BCN (01) | MI |
4312641 | (05) | MI |
4363533 | (05) | MI |
47526 | OMNICARE HEALTH PLAN (01) | MI |
5338131 | AETNA (01) | MI |
G08062 | (02) | MI |
G08062 | HAP (01) | MI |
P87561 | BCN (01) | MI |