| Ideal Home Physicians Pc | |
|
21700 Northwestern Hwy Suite 801 Southfield MI 48075-4906 | |
| (248) 440-0920 | |
| (248) 440-0929 |
| Full Name | Ideal Home Physicians Pc |
|---|---|
| Speciality | General Practice |
| Location | 21700 Northwestern Hwy, Southfield, Michigan |
| Authorized Official Name and Position | Adekunle Emmanuel Oshiyoye (CEO) |
| Authorized Official Contact | 2484400920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Home Physicians Pc Po Box 251062 W Bloomfield MI 48325-1062 Ph: (248) 440-0920 | Ideal Home Physicians Pc 21700 Northwestern Hwy Suite 801 Southfield MI 48075-4906 Ph: (248) 440-0920 |
| NPI Number | 1740478270 |
|---|---|
| Provider Enumeration Date | 10/10/2007 |
| Last Update Date | 04/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740478270 | NPI | - | NPPES |
| 0F33532 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | AO060924 (Michigan) | Primary |
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