Healthcare Provider Details

I. General information

NPI: 1568625366
Provider Name (Legal Business Name): CONTINUUM GERIATRIC SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 E GRAND RIVER AVE
BRIGHTON MI
48116-1804
US

IV. Provider business mailing address

17800 NEWBURGH RD SUITE 103
LIVONIA MI
48152-2700
US

V. Phone/Fax

Practice location:
  • Phone: 734-464-9540
  • Fax:
Mailing address:
  • Phone: 734-464-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS SELZNICK
Title or Position: PRESIDENT
Credential: DO
Phone: 734-464-9540