| Home Visit M.d., Plc | |
|
26206 W 12 Mile Rd Ste 302 Southfield MI 48034-8501 | |
| (248) 440-6090 | |
| (248) 440-6094 |
| Full Name | Home Visit M.d., Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 26206 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Reginald N Eburuche (OWNER) |
| Authorized Official Contact | 2484406090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Visit M.d., Plc P. O. Box 250077 Franklin MI 48025 Ph: (248) 440-6090 | Home Visit M.d., Plc 26206 W 12 Mile Rd Ste 302 Southfield MI 48034-8501 Ph: (248) 440-6090 |
| NPI Number | 1205964012 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 03/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205964012 | NPI | - | NPPES |
| 470773210 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301080385 (Michigan) | Primary |
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