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General NPI Number Information
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NPI Number | 1134660376
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Entity Type | Organization
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Legal Business Name | HOME VISITING DOCTORS PLLC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 17515 W 9 MILE RD STE 180
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4400
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Country | US
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Telephone | 734-276-6501
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Fax |
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Provider Business Mailing Address
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Address Line | 17515 W 9 MILE RD STE 180
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4400
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Country | US
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Telephone | 734-276-6501
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | BABU KONERU
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Credential |
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Telephone | 734-276-6501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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