Provider Demographics
NPI:1467442707
Name:PARMELY, JOHN D (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:PARMELY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:28080 GRAND RIVER AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5966
Mailing Address - Country:US
Mailing Address - Phone:248-471-8865
Mailing Address - Fax:248-478-7789
Practice Address - Street 1:28080 GRAND RIVER AVE
Practice Address - Street 2:STE 208
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5966
Practice Address - Country:US
Practice Address - Phone:248-471-8865
Practice Address - Fax:248-478-7789
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2013-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI009784208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4274353Medicaid
5630238OtherBCBS
F14801Medicare UPIN
0N21070Medicare ID - Type Unspecified