Healthcare Provider Details

I. General information

NPI: 1871669630
Provider Name (Legal Business Name): PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 EASTGATE RD SUITE NUMBER C
TOLEDO OH
43614-3082
US

IV. Provider business mailing address

1850 EASTGATE RD SUITE NUMBER C
TOLEDO OH
43614-3082
US

V. Phone/Fax

Practice location:
  • Phone: 313-350-0027
  • Fax: 248-865-7356
Mailing address:
  • Phone: 313-350-0027
  • Fax: 248-865-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: CHUKWUDI A NNAJI
Title or Position: OWNER
Credential:
Phone: 313-350-0027