Provider Demographics
NPI:1689221178
Name:DUBOIS, JAMES CEDRIC JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CEDRIC
Last Name:DUBOIS
Suffix:JR
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 1:32715 DORSEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4755
Mailing Address - Country:US
Mailing Address - Phone:734-641-1141
Mailing Address - Fax:
Practice Address - Street 1:32715 DORSEY ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4755
Practice Address - Country:US
Practice Address - Phone:734-641-1141
Practice Address - Fax:734-641-1142
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist