Healthcare Provider Details

I. General information

NPI: 1427056514
Provider Name (Legal Business Name): ZICHI-PHILLIPS ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 01/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18600 VAN HORN RD
WOODHAVEN MI
48183-3828
US

IV. Provider business mailing address

18600 VAN HORN RD
WOODHAVEN MI
48183-3828
US

V. Phone/Fax

Practice location:
  • Phone: 734-675-0300
  • Fax:
Mailing address:
  • Phone: 734-675-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number234521
License Number StateMI

VIII. Authorized Official

Name: DR. ABDUL CHOUDRY
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 734-675-0300