Provider Demographics
NPI:1154392439
Name:DOBBIE, MAUREEN M (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:M
Last Name:DOBBIE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:BOX 42
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7806
Mailing Address - Fax:269-341-8743
Practice Address - Street 1:5629 STADIUM DR
Practice Address - Street 2:STE B BRONSON INTERNAL MEDICINE OSHTEMO
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1952
Practice Address - Country:US
Practice Address - Phone:269-544-3276
Practice Address - Fax:269-544-3288
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704199981363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4594648Medicaid
MI4594648Medicaid