Provider Demographics
NPI:1841361219
Name:HATCHER, DONALD MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:MICHAEL
Last Name:HATCHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48303
Mailing Address - Country:US
Mailing Address - Phone:248-514-7411
Mailing Address - Fax:248-994-1054
Practice Address - Street 1:33045 HAMILTON COURT
Practice Address - Street 2:SUITE 260
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-514-7411
Practice Address - Fax:248-994-1054
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010322103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N71950Medicare ID - Type Unspecified