Healthcare Provider Details

I. General information

NPI: 1487717666
Provider Name (Legal Business Name): HARMONY INTERNATIONAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 GREENFIELD RD #402 NORTHLAND MEDICAL TOWER
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

PO BOX 1087 HARMONY HEALTH CHOICE
FREDERICK MD
21702
US

V. Phone/Fax

Practice location:
  • Phone: 248-436-1959
  • Fax: 248-436-1978
Mailing address:
  • Phone: 248-436-1959
  • Fax: 248-436-1978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number430141053
License Number StateMI

VIII. Authorized Official

Name: DR. JONATHAN AGBEBIYI
Title or Position: PHYSICIAN CEO
Credential: MD
Phone: 248-436-1959