Provider Demographics
NPI:1700933371
Name:DIONNE, MICHAEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:DIONNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:131 KERCHEVAL AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3628
Mailing Address - Country:US
Mailing Address - Phone:313-885-5700
Mailing Address - Fax:313-885-5705
Practice Address - Street 1:131 KERCHEVAL AVE STE 330
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3628
Practice Address - Country:US
Practice Address - Phone:313-885-5700
Practice Address - Fax:313-885-5705
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI047871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMD 047871OtherSTATE LICENSE
MIMD 047871OtherSTATE LICENSE