Healthcare Provider Details

I. General information

NPI: 1841963899
Provider Name (Legal Business Name): ADFINITAS HEALTH PALLIATIVE SERVICES OF MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US

IV. Provider business mailing address

7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-0814
  • Fax: 443-949-0825
Mailing address:
  • Phone: 443-949-0814
  • Fax: 443-949-0825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY C. LONG
Title or Position: CHIEF ADMIN OFFICER
Credential:
Phone: 443-949-0814