Healthcare Provider Details

I. General information

NPI: 1730373440
Provider Name (Legal Business Name): METRO HOME VISITING PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 12/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32854 FIVE MILE RD
LIVONIA MI
48154-3048
US

IV. Provider business mailing address

32854 FIVE MILE RD
LIVONIA MI
48154-3048
US

V. Phone/Fax

Practice location:
  • Phone: 734-266-8036
  • Fax:
Mailing address:
  • Phone: 734-266-8036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301087633
License Number StateMI

VIII. Authorized Official

Name: DR. ZONGLI CHANG
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 614-218-5764