Provider Demographics
NPI:1790794253
Name:DOSH, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:DOSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3409 LUDINGTON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-4212
Mailing Address - Country:US
Mailing Address - Phone:906-786-5707
Mailing Address - Fax:906-789-4446
Practice Address - Street 1:3409 LUDINGTON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-4212
Practice Address - Country:US
Practice Address - Phone:906-786-5707
Practice Address - Fax:906-789-4446
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301041801207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3177838Medicaid
MI110144741OtherRR MEDICARE GROUP#CC2139
MI0M05250004Medicare ID - Type Unspecified
MIA74557Medicare UPIN