1346339249 NPI number — DR. PATRICE MARIE DUQUETTE M.D.

Table of content: DR. PATRICE MARIE DUQUETTE M.D. (NPI 1346339249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346339249 NPI number — DR. PATRICE MARIE DUQUETTE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUQUETTE
Provider First Name:
PATRICE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346339249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25328 HENLEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON WOODS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48070-1707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-798-3340
Provider Business Mailing Address Fax Number:
248-594-7663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 N OLD WOODWARD AVE STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48009-5392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-594-7690
Provider Business Practice Location Address Fax Number:
248-327-1748
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  4301054935 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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