MEDICARE: CITY OF DETROIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302F00000X	Exclusive Provider Organization	822951	MI

General Provider Information

NPI Number	:	1346379492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF DETROIT

Provider Business Mailing Address
First Line	:	1151 TAYLOR ST RM 319B
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-1732
Country	:	US
Telephone Number	:	313-876-4564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 TAYLOR ST RM 319B
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-1732
Country	:	US
Telephone Number	:	313-876-4564
Fax Number	:

Authorized Official
Title or Position	:	DEP. DIRECTOR
Name	:	DR. KANZONI NEUMANN ASABIGI
Credential	:	MD, MPH, MBA
Telephone Number	:	313-876-4564

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	06/16/2008

Similar Medicare Providers

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Practice Location Address:

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Practice Location Address:

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1093846974 — MONA RIZK IBRAHIM DDS, MPH, MS
Practice Location Address:

DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX , 1151 TAYLOR STREET, 7TH FLOOR PEDIATRIC DENTAL CLINIC
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Practice Location Address:

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1619009933 — CHRISTINE L. WILLIAMS DENTAL HYGIENIST
Practice Location Address:

DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX , 1151 TAYLOR STREET, ADULT DENTAL CLINIC , WING 1C
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Practice Location Address:

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Directions to “CITY OF DETROIT ” Practice Location

Language	Start Address	Practice Location

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