Individual provider · Type 1 NPI

Cory Bockenhauer, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1104672989 Active

Practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Call (313) 745-7329 Map

Mailing address

11606 Lori Ln
Huntley, IL 60142-7308

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104672989

Cory Bockenhauer, MD's National Provider Identifier is 1104672989, issued on Apr 24, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Apr 24, 2024.