Healthcare Provider Details

I. General information

NPI: 1821684192
Provider Name (Legal Business Name): TEAMMD PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 TOWN CTR STE 4000
SOUTHFIELD MI
48075-1102
US

IV. Provider business mailing address

9900 BREN RD E # NJ975
HOPKINS MN
55343-9664
US

V. Phone/Fax

Practice location:
  • Phone: 800-957-6046
  • Fax:
Mailing address:
  • Phone: 800-957-6046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA BRUHL
Title or Position: PRESIDENT
Credential:
Phone: 515-991-0542