Dubois Medical Enterprises PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DUBOIS MEDICAL ENTERPRISES PC

Practice address

8540 105TH Ave
Stanwood, MI 49346-9764

Phone

(231) 972-2710

Fax

(231) 972-2712

NPI assigned

Jul 21, 2006

Last updated

Jun 2, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Frederick Dubois, M.D.

Title

Owner

Phone

(231) 972-2710

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Eastside Family Medical Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1073534392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 105TH AVE",
            "city": "STANWOOD",
            "state": "MI",
            "postal_code": "493469764",
            "telephone_number": "231-972-2710",
            "fax_number": "231-972-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 105TH AVE",
            "city": "STANWOOD",
            "state": "MI",
            "postal_code": "493469764",
            "telephone_number": "231-972-2710",
            "fax_number": "231-972-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS MEDICAL ENTERPRISES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "DUBOIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-972-2710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0E46007",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Family Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Rural Health Clinic/Center in Stanwood, MI
• Providers in Stanwood, MI by specialty
• Rural Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.