Provider Demographics
NPI:1851690341
Name:PATRICIA DULEY MDPC
Entity Type:Organization
Organization Name:PATRICIA DULEY MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-732-8986
Mailing Address - Street 1:606 N COURT AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1516
Mailing Address - Country:US
Mailing Address - Phone:989-732-8986
Mailing Address - Fax:989-731-1737
Practice Address - Street 1:606 N COURT AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1516
Practice Address - Country:US
Practice Address - Phone:989-732-8986
Practice Address - Fax:989-731-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406951207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2904509Medicaid
MIF00423Medicare UPIN
MI2904509Medicaid