Provider Demographics
NPI:1417964552
Name:HOWLIN, DIANE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:HOWLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1620 COMMERCE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1620
Mailing Address - Country:US
Mailing Address - Phone:734-475-2921
Mailing Address - Fax:734-475-2945
Practice Address - Street 1:1620 COMMERCE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1620
Practice Address - Country:US
Practice Address - Phone:734-475-2921
Practice Address - Fax:734-475-2945
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4257684Medicaid
MI0P11860Medicare ID - Type Unspecified
MI4257684Medicaid