Provider Demographics
NPI:1508571068
Name:DASHER MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:DASHER MEDICAL GROUP PLLC
Other - Org Name:DASHER FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DASHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-664-6147
Mailing Address - Street 1:50769 SNOWMASS CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-7716
Mailing Address - Country:US
Mailing Address - Phone:734-664-6147
Mailing Address - Fax:
Practice Address - Street 1:45211 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-1001
Practice Address - Country:US
Practice Address - Phone:734-664-6147
Practice Address - Fax:734-769-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty