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General NPI Number Information
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NPI Number | 1033301569
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Entity Type | Organization
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Legal Business Name | BAN MECHAEL, MD PC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 19930 FARMINGTON RD SUITE A
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City | LIVONIA
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State | MI
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Zip | 48152-1433
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Country | US
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Telephone | 248-476-6209
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Fax | 248-476-6237
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Provider Business Mailing Address
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Address Line | 19930 FARMINGTON RD SUITE A
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City | LIVONIA
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State | MI
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Zip | 48152-1433
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Country | US
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Telephone | 248-476-6209
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Fax | 248-476-6237
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAN MECHAEL
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Credential | M.D.
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Telephone | 248-476-6209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301073200
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License Number State | MI
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