Provider Demographics
NPI:1083058366
Name:DMC CONSULTANT GROUP, WBE LLC
Entity Type:Organization
Organization Name:DMC CONSULTANT GROUP, WBE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:CONLEY-MORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-565-8960
Mailing Address - Street 1:103 EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2010
Mailing Address - Country:US
Mailing Address - Phone:315-565-8960
Mailing Address - Fax:315-299-6257
Practice Address - Street 1:103 EDGEMONT DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2010
Practice Address - Country:US
Practice Address - Phone:315-565-8960
Practice Address - Fax:315-299-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization