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NPI Code Detail

MEDICARE: STAT PHYSICIAN PC

MEDICARE: STAT PHYSICIAN PC
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
1207R00000XInternal Medicine Physician4301071426MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811026479
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAT PHYSICIAN PC
Provider Business Mailing Address
First Line : 2710 S ROCHESTER RD
Second Line : SUITE E
City : ROCHESTER HILLS
State : MI
Zip : 48307-4547
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2710 S ROCHESTER RD
Second Line : SUITE E
City : ROCHESTER HILLS
State : MI
Zip : 48307-4547
Country : US
Telephone Number : 248-853-9097
Fax Number : 248-852-0347
Authorized Official
Title or Position : MD
Name : GURSHARANJIT SINGH DHILLON
Credential :
Telephone Number : 248-214-8722
Provider Enumeration Date : 03/02/2007
Last Update Date : 08/22/2020

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