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General NPI Number Information
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NPI Number | 1104069301
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Entity Type | Organization
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Legal Business Name | FENKELL MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 10101 FENKELL ST
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City | DETROIT
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State | MI
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Zip | 48238-1645
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Country | US
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Telephone | 810-423-2308
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Fax |
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Provider Business Mailing Address
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Address Line | 27950 ORCHARD LAKE RD STE 116
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3758
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAMESH L CHHEDA
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Credential | MD
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Telephone | 810-423-2308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4301045264
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License Number State | MI
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