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General NPI Number Information
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NPI Number | 1134637275
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Entity Type | Organization
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Legal Business Name | RESIDENTIAL VISITING PHYSICIAN SERVICES PLLC.
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 34020 7 MILE RD STE 113
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City | LIVONIA
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State | MI
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Zip | 48152-3093
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Country | US
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Telephone | 734-516-3746
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Fax |
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Provider Business Mailing Address
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Address Line | 34020 7 MILE RD STE 113
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City | LIVONIA
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State | MI
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Zip | 48152-3093
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Country | US
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Telephone | 313-825-8909
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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. SHAHID M ANSARI
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Credential | MD
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Telephone | 734-516-3746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301059174
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License Number State | MI
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