Provider Demographics
NPI:1679004238
Name:DUSENBERY, ANNA CLAIRE (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CLAIRE
Last Name:DUSENBERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 NORMA RD
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9396
Mailing Address - Country:US
Mailing Address - Phone:215-840-6832
Mailing Address - Fax:
Practice Address - Street 1:8192 JACKSON RD STE A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9194
Practice Address - Country:US
Practice Address - Phone:734-527-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301506386207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology