Provider Demographics
NPI:1245615616
Name:BILBO, DUANE X
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:
Last Name:BILBO
Suffix:X
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-2505
Mailing Address - Country:US
Mailing Address - Phone:248-334-6502
Mailing Address - Fax:
Practice Address - Street 1:574 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2505
Practice Address - Country:US
Practice Address - Phone:248-334-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health