Livernois Family Medical Svc
Physician Assistant, Medical in Detroit, MI. Organization (NPI-2).
NPI number1063762003
StatusActive
Last updated in NPPESSep 18, 2012
Details
- NPI
- 1063762003
- Entity type
- Organization (NPI-2)
- Legal business name
- Livernois Family Medical Svc
- Organization subpart
- No
- Enumeration date
- Sep 18, 2012
- Last updated
- Sep 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
| 282N00000X | General Acute Care Hospital | – | – |
Practice location
18254 Livernois AveDetroit, MI 48221-4214
Phone 313-861-4400
Mailing address
18254 Livernois AveDetroit, MI 48221-4214
Authorized official
Murtaza Hussain Hussain
Physician
3138614400
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