Individual provider · Type 1 NPI
Dima Sprague
Surgical Physician Assistant · Warren, MI
NPI number
1275872376
Active
Practice location
28800 Ryan Rd
Warren, MI 48092-4272
Mailing address
6924 Appoline St, Upper Level
Dearborn, MI 48126-1989
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 5601006517 (MI) |
| Surgical Physician Assistant Primary | 363AS0400X | 5601006517 (MI) |
Surgical Physician Assistant: Definition to come...
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About NPI 1275872376
Dima Sprague's National Provider Identifier is 1275872376, issued on Feb 8, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Warren, MI. The record was last updated on Feb 21, 2017.