Healthcare Provider Details

I. General information

NPI: 1790512168
Provider Name (Legal Business Name): RM MEDICAL MI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 26 MILE RD STE 300
SHELBY TOWNSHIP MI
48316-5139
US

IV. Provider business mailing address

37595 7 MILE RD STE 400
LIVONIA MI
48152-1489
US

V. Phone/Fax

Practice location:
  • Phone: 586-992-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBERT MUSSON
Title or Position: OWNER-AUTHORIZED OFFICIAL
Credential: MD
Phone: 586-992-8300