Healthcare Provider Details

I. General information

NPI: 1467487603
Provider Name (Legal Business Name): GERIATRIC CARE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38253 ANN ARBOR RD
LIVONIA MI
48150-3432
US

IV. Provider business mailing address

38253 ANN ARBOR RD
LIVONIA MI
48150-3432
US

V. Phone/Fax

Practice location:
  • Phone: 734-464-9200
  • Fax: 734-464-0017
Mailing address:
  • Phone: 734-464-9200
  • Fax: 734-464-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK DOUGLAS WINTERS
Title or Position: PARTNER
Credential: D. O.
Phone: 734-464-9200