Provider Demographics
NPI:1902517956
Name:CAIN, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:CAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29450 MUNRO ST
Mailing Address - Street 2:
Mailing Address - City:GIBRALTAR
Mailing Address - State:MI
Mailing Address - Zip Code:48173-9720
Mailing Address - Country:US
Mailing Address - Phone:734-676-3167
Mailing Address - Fax:
Practice Address - Street 1:29450 MUNRO ST
Practice Address - Street 2:
Practice Address - City:GIBRALTAR
Practice Address - State:MI
Practice Address - Zip Code:48173-9720
Practice Address - Country:US
Practice Address - Phone:734-676-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic