Healthcare Provider Details
I. General information
NPI: 1699590075
Provider Name (Legal Business Name): HOME PHYSICIANS TEAM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 E MAPLE RD # 211
BIRMINGHAM MI
48009-6324
US
IV. Provider business mailing address
261 E MAPLE RD # 211
BIRMINGHAM MI
48009-6324
US
V. Phone/Fax
- Phone: 947-800-5458
- Fax: 313-486-0000
- Phone: 248-719-0103
- Fax: 313-486-0000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SALVADOR
ROJAS
III
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 947-800-5458