Healthcare Provider Details

I. General information

NPI: 1184402745
Provider Name (Legal Business Name): FIRSTHAND HEALTH OF MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7445 ALLEN RD STE 270
ALLEN PARK MI
48101-1963
US

IV. Provider business mailing address

1032 E BRANDON BLVD STE 4567
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 844-348-4263
  • Fax:
Mailing address:
  • Phone: 201-474-5844
  • Fax: 855-737-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA PURDY
Title or Position: OWNER
Credential: MD
Phone: 201-474-5844