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At Home Physicians, PC

Community Health Worker in Southfield, MI. Organization (NPI-2).

NPI number1154628204
StatusActive
Last updated in NPPESMar 4, 2011

Details

NPI
1154628204
Entity type
Organization (NPI-2)
Legal business name
At Home Physicians, PC
Organization subpart
No
Enumeration date
Feb 24, 2011
Last updated
Mar 4, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

23155 Northwestern Hwy
Suite 401
Southfield, MI 48075-7703

Phone 248-304-1700 · Fax 248-304-1720

Mailing address

23155 Northwestern Hwy
Suite 401
Southfield, MI 48075-7703

Phone 248-304-1700 · Fax 248-304-1720

Authorized official

Leonard Eugene Ellison
President
3134779545

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