Conor Dahlquist
Individual provider Active NPI Other Technician · Ada, MI
NPI 1447616628 · NPPES record last updated Jan 4, 2016
Key facts
- NPI
- 1447616628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 2122 Watercrest Ave NE
Ada, MI 49301-8120 - Phone
- (616) 307-0994
- NPI assigned
- Jan 4, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
2122 Watercrest Ave NE
Ada, MI 49301-8120
Mailing address
2122 Watercrest Ave NE
Ada, MI 49301-8120
Phone (616) 307-0994
Other providers in Ada, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.