Healthcare Provider Details

I. General information

NPI: 1861269755
Provider Name (Legal Business Name): HEALTH PARTNERS OF MICHIGAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8425 W MCNICHOLS RD
DETROIT MI
48221-2546
US

IV. Provider business mailing address

30600 TELEGRAPH RD
BINGHAM FARMS MI
48025-4530
US

V. Phone/Fax

Practice location:
  • Phone: 281-962-8878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILLIP LEVY
Title or Position: CHAIRMAN
Credential: MD
Phone: 313-745-3000