Excellence Home Physicians
Internal Medicine in Troy, MI. Organization (NPI-2).
NPI number1609391382
StatusActive
Last updated in NPPESJan 16, 2023
Details
- NPI
- 1609391382
- Entity type
- Organization (NPI-2)
- Legal business name
- Excellence Home Physicians
- Organization subpart
- No
- Enumeration date
- Aug 3, 2017
- Certification date
- Jan 16, 2023
- Last updated
- Jan 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 213EP1101X | Podiatrist, Primary Podiatric Medicine | – | – | |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Practice location
3150 Livernois Rd Ste 165Troy, MI 48083-5061
Phone 248-996-8446 · Fax 248-996-8261
Mailing address
3150 Livernois Rd Ste 165Troy, MI 48083-5061
Phone 248-996-8446 · Fax 248-996-8261
Authorized official
Geoffrey Jimenez
Owner
3102767388
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