Provider Demographics
NPI:1053468850
Name:DOSS, DOSS NICOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DOSS
Middle Name:NICOLAS
Last Name:DOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:D.NICOLAS
Other - Middle Name:
Other - Last Name:DOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PH D
Mailing Address - Street 1:HENRY FORD HEALTH SYSTEM
Mailing Address - Street 2:5500 AUTO CLUB DR
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126
Mailing Address - Country:US
Mailing Address - Phone:313-425-4700
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD HEALTH SYSTEM
Practice Address - Street 2:5500 AUTO CLUB DR
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126
Practice Address - Country:US
Practice Address - Phone:313-425-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI352240110Medicaid
700H262280OtherBLUE CROSS-BLUE CROSS
DD063138OtherCHAMPUS-CHAMPUS
DD063138OtherCOMMERCIAL-COMMERCIAL NUMBER
MI352240110Medicaid
0H26228271Medicare ID - Type Unspecified