Provider Demographics
NPI:1952975161
Name:HUBBELL, NATALIE MICHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:MICHELLE
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 S DIXIELAND RD APT T301
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1813
Mailing Address - Country:US
Mailing Address - Phone:316-303-2177
Mailing Address - Fax:
Practice Address - Street 1:DETROIT MEDICAL CENTER GME OFFICE
Practice Address - Street 2:4201 ST. ANTOINE UHC-9C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026248APP21207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine