Healthcare Provider Details

I. General information

NPI: 1013262948
Provider Name (Legal Business Name): HOWARD ROBERT CURTIS JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 W MCNICHOLS RD STE 210
DETROIT MI
48221-2357
US

IV. Provider business mailing address

11000 W MCNICHOLS RD STE 210
DETROIT MI
48221-2357
US

V. Phone/Fax

Practice location:
  • Phone: 313-340-4442
  • Fax: 313-340-4443
Mailing address:
  • Phone: 313-340-4442
  • Fax: 313-340-4443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704271431
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: