Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Michael Dimock

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992648075

Ethan Michael Dimock is a Student in an Organized Health Care Education/Training Program in Detroit, Michigan. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone: (313) 745-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1992648075
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 13, 2026
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026

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