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Contact Information

WISSAM DIMACHK, DPM
11900 E 12 MILE RD STE 102
WARREN, MI48093
 Phone: 586-573-7470
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for WISSAM DIMACHK · (Male)

NPI Number 1598151128
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 04/10/2015
Last updated 07/04/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5901002567
Hospital affiliation(s)
  • ST JOHN HOSPITAL AND MEDICAL CENTER - (Acute Care)
    22101 MOROSS RD
    DETROIT, MI 48236
  • ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER - (Acute Care)
    11800 EAST TWELVE MILE ROAD
    WARREN, MI 48093
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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