Healthcare Provider Details

I. General information

NPI: 1124338488
Provider Name (Legal Business Name): CITY OF DETROIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 E JEFFERSON AVE STE 100
DETROIT MI
48207-4222
US

IV. Provider business mailing address

1151 TAYLOR ST # 111C
DETROIT MI
48202-1732
US

V. Phone/Fax

Practice location:
  • Phone: 313-876-4000
  • Fax:
Mailing address:
  • Phone: 313-876-4307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. KANZONI ASABIGI
Title or Position: SENIOR PUBLIC HEALTH ADVISOR
Credential:
Phone: 313-867-4000