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General NPI Number Information
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NPI Number | 1144607771
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 33608 PALMER RD
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City | WESTLAND
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State | MI
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Zip | 48186-4673
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Country | US
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Telephone | 734-710-6688
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Fax | 734-710-6612
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Provider Business Mailing Address
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Address Line | 518 HARRIET ST PO BOX 980311
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City | YPSILANTI
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State | MI
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Zip | 48197-5358
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Country | US
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Telephone | 734-484-2989
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Fax | 734-484-6825
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MATTHEW HUDSON
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Credential |
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Telephone | 734-484-2989
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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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