Healthcare Provider Details
I. General information
NPI: 1588979686
Provider Name (Legal Business Name): HARMONY TURNING POINT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2010
Last Update Date: 04/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20755 GREENFIELD RD SUITE 100
SOUTHFIELD MI
48075-5403
US
IV. Provider business mailing address
20755 GREENFIELD RD SUITE 100
SOUTHFIELD MI
48075-5403
US
V. Phone/Fax
- Phone: 248-275-3180
- Fax:
- Phone: 248-275-3180
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 4301041053 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 4301041053 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 4301041053 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | 4301041053 |
| License Number State | MI |
VIII. Authorized Official
Name:
JONATHAN
AGBEBIYI
Title or Position: CEO
Credential: M.D.
Phone: 248-275-3180