Healthcare Provider Details

I. General information

NPI: 1134504343
Provider Name (Legal Business Name): ROYAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12724 W 9 MILE RD
OAK PARK MI
48237-2959
US

IV. Provider business mailing address

12724 W 9 MILE RD
OAK PARK MI
48237-2959
US

V. Phone/Fax

Practice location:
  • Phone: 313-510-0840
  • Fax:
Mailing address:
  • Phone: 313-510-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: NAVEEN MAJETY
Title or Position: MANAGER
Credential:
Phone: 301-560-7154