Dutkevicz, Michael M

Dutkevicz, Michael M is an individual health care provider with primary practice located at 135 Professional Pl , Bridgeport WV 26330-4509. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dutkevicz, Michael M can be contacted via phone (681) 342-3680.

Contact Information

Primary practice address
135 Professional Pl Bridgeport WV 26330-4509
Phone: (681) 342-3680
Fax: (681) 342-3665
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1809 West Virginia

Profile Details

NPI number 1902803331
LBN Legal business name Dutkevicz, Michael M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated May 20th, 2015 - about 11 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 1902803331 NPPES
Ohio MEDICAID 0070754

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