Provider Demographics
NPI:1215003819
Name:ENGERER, DENNIS E (PT)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:E
Last Name:ENGERER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1681
Mailing Address - Country:US
Mailing Address - Phone:248-349-9339
Mailing Address - Fax:248-349-9342
Practice Address - Street 1:215 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1681
Practice Address - Country:US
Practice Address - Phone:248-349-9339
Practice Address - Fax:248-349-9342
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501002317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOH20094OtherBCBS
MI500573OtherCARE CHOICES
MI16869OtherPARTNERSHIP HEALTH
MI7543420OtherAETNA
MIP00100555OtherMEDICARE RAILROAD
MI16869OtherM-CARE
MI0N58620OtherHAP
MI7543420OtherAETNA