Northwest Detroit Dialysis Center LLC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Southfield, MI. Organization (NPI-2).
NPI number1295047710
StatusActive
Last updated in NPPESOct 25, 2012
Details
- NPI
- 1295047710
- Entity type
- Organization (NPI-2)
- Legal business name
- Northwest Detroit Dialysis Center LLC
- Organization subpart
- No
- Enumeration date
- Jul 13, 2010
- Last updated
- Oct 25, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | B8672P | MI | Yes |
Practice location
21000 Northwestern HwySouthfield, MI 48075-5306
Phone 248-557-7000 · Fax 248-557-7786
Mailing address
30100 Telegraph RdSte 200
Bingham Farms, MI 48025-4516
Phone 248-642-5038 · Fax 248-642-7140
Authorized official
David F Shepherd
Vice President
2486425038
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