Kubek, Douglas Carl
Kubek, Douglas Carl is an individual health care provider with primary practice located at 21000 E 12 Mile Rd Ste 111, Saint Clair Shores MI 48081-1156. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Kubek, Douglas Carl can be contacted via phone (586) 779-7610.Contact Information
Primary practice address
21000 E 12 Mile Rd Ste 111
Saint Clair Shores MI 48081-1156
Phone: (586) 779-7610
Fax: (586) 779-1391
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207YS0012X | 5101012806 | Michigan |
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 5101012806 | Michigan |
Profile Details
| NPI number | 1003903832 |
|---|---|
| LBN Legal business name | Kubek, Douglas Carl |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Mar 9th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003903832 | NPPES |
| Michigan | Other | 0455010215 | BCBSM |
| Michigan | Other | 14075 | BCBSM |
| Michigan | Other | 040E061920 | BCBSM |
| Michigan | Other | 133060 | BCBSM |
| Michigan | Other | 104200 | BCBSM |
| Michigan | MEDICAID | 4535235 | BCBSM |
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