Detorres, Frederick Michael

Detorres, Frederick Michael is an sole proprietor health care provider with primary practice located at 6215 Harvey St , Muskegon MI 49444-9739. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Detorres, Frederick Michael can be contacted via phone (231) 799-8777.

Contact Information

Primary practice address
6215 Harvey St Muskegon MI 49444-9739
Phone: (231) 799-8777
Fax: (231) 798-7423
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X FD055364 Michigan

Profile Details

NPI number 1518023480
LBN Legal business name Detorres, Frederick Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518023480 NPPES
Michigan MEDICAID 3478831
Michigan Other FD055634
Michigan Other 0618234

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