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1316459399
DMITRI ALEXANDROVICH KAPOUSTA
ANN ARBOR, MI
NPI
1316459399
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704299965)
Enumeration Date
2017-10-30
Last Update Date
2018-12-19
Business Address
DMITRI ALEXANDROVICH KAPOUSTA NP
1500 EAST MEDICAL CENTER DR 2ND FLOOR TAUBMAN CTR RECP F
ANN ARBOR, MI 48109-5332
Phone number: 734-936-5738
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Mailing Address
DMITRI ALEXANDROVICH KAPOUSTA NP
3621 S STATE ST
ANN ARBOR, MI 48108-1633
Phone number: 734-647-5299
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