Healthcare Provider Details

I. General information

NPI: 1427297712
Provider Name (Legal Business Name): HOSPITALIST & PALLIATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18181 OAKWOOD BLVD SUITE 208
DEARBORN MI
48124-5032
US

IV. Provider business mailing address

18181 OAKWOOD BLVD SUITE 208
DEARBORN MI
48124-5032
US

V. Phone/Fax

Practice location:
  • Phone: 313-271-5565
  • Fax: 313-563-3342
Mailing address:
  • Phone: 313-271-5565
  • Fax: 313-563-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: SONALI WILBORN
Title or Position: OWNER
Credential: MD
Phone: 313-563-3332