Provider Demographics
NPI:1730656273
Name:MICHAEL DUCATO MD, PC
Entity Type:Organization
Organization Name:MICHAEL DUCATO MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-291-4444
Mailing Address - Street 1:2901 WEST RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2472
Mailing Address - Country:US
Mailing Address - Phone:734-676-6644
Mailing Address - Fax:734-675-1858
Practice Address - Street 1:2901 WEST RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2472
Practice Address - Country:US
Practice Address - Phone:734-676-6644
Practice Address - Fax:734-675-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty