Healthcare Provider Details
I. General information
NPI: 1972605707
Provider Name (Legal Business Name): MD HOUSE CALLS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/02/2006
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27760 FRANKLIN RD
SOUTHFIELD MI
48034-2300
US
IV. Provider business mailing address
1600 KILBURN RD N
ROCHESTER HILLS MI
48306-3027
US
V. Phone/Fax
- Phone: 586-530-8598
- Fax:
- Phone: 586-530-8598
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | 4301061154 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
EDWIN
S
STONE
II
Title or Position: CEO
Credential: M.D.
Phone: 586-530-8598