Provider Demographics
NPI:1790971653
Name:JOHN D PARMELY DO PC
Entity Type:Organization
Organization Name:JOHN D PARMELY DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARMELY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-471-8829
Mailing Address - Street 1:28080 GRAND RIVER AVE
Mailing Address - Street 2:STE 207N
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5966
Mailing Address - Country:US
Mailing Address - Phone:248-471-8829
Mailing Address - Fax:248-471-8352
Practice Address - Street 1:28080 GRAND RIVER AVE
Practice Address - Street 2:STE 207N
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5966
Practice Address - Country:US
Practice Address - Phone:248-471-8829
Practice Address - Fax:248-471-8352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N81820Medicare PIN