Healthcare Provider Details
I. General information
NPI: 1427840586
Provider Name (Legal Business Name): INHOSPITAL PHYSICIANS MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 ELECTRIC AVE
PORT HURON MI
48060-6587
US
IV. Provider business mailing address
350 SENTRY PARKWAY, BLDG- 660, STE-102
BLUE BELL PA
19422
US
V. Phone/Fax
- Phone: 484-965-9566
- Fax: 484-965-9567
- Phone: 484-965-9566
- Fax: 484-965-9566
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CAREY VEMULA
WILLIAM
Title or Position: CO-CEO
Credential: MD
Phone: 856-294-8435