Dittenbir, Mark A

Dittenbir, Mark A is an individual health care provider with primary practice located at 601 John St Ste M283A , Kalamazoo MI 49007-5341. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Dittenbir, Mark A can be contacted via phone (269) 349-7696.

Contact Information

Primary practice address
601 John St Ste M283A Kalamazoo MI 49007-5341
Phone: (269) 349-7696
Fax: (269) 488-8313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 4301048692 Michigan
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301048692 Michigan

Profile Details

NPI number 1942249727
LBN Legal business name Dittenbir, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated May 1st, 2018 - about 8 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 1942249727 NPPES
Michigan Other 020C91020 BCBS GRP PIN
Michigan Other 3403901640 BCBS GRP PIN
Michigan Other 5515041 BCBS GRP PIN
Michigan Other 116658 BCBS GRP PIN
Michigan Other 1417961137 BCBS GRP PIN
Michigan MEDICAID 1942249727 BCBS GRP PIN
Michigan MEDICAID 3218986-10 BCBS GRP PIN

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