Healthcare Provider Details

I. General information

NPI: 1518167618
Provider Name (Legal Business Name): SARAH NICHOLE DEIGHTON-COLLINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47601 GRAND RIVER AVE
NOVI MI
48374-1233
US

IV. Provider business mailing address

47601 GRAND RIVER AVE
NOVI MI
48374-1233
US

V. Phone/Fax

Practice location:
  • Phone: 248-465-4100
  • Fax:
Mailing address:
  • Phone: 248-465-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301090726
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: