Healthcare Provider Details

I. General information

NPI: 1083762793
Provider Name (Legal Business Name): NEW HORIZONS MEDICAL CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19335 MERRIMAN RD
LIVONIA MI
48152-1754
US

IV. Provider business mailing address

19335 MERRIMAN RD
LIVONIA MI
48152-1754
US

V. Phone/Fax

Practice location:
  • Phone: 248-474-4900
  • Fax:
Mailing address:
  • Phone: 248-474-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SEAN PATRICK COYLE
Title or Position: PRESIDENT
Credential: MD
Phone: 248-474-4900