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General NPI Number Information
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NPI Number | 1164846929
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Entity Type | Organization
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Legal Business Name | NELLI MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1349 S ROCHESTER RD SUITE 115
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-3150
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Country | US
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Telephone | 248-759-4852
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Fax | 248-299-9860
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Provider Business Mailing Address
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Address Line | 5827 CALGARY CT
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-3070
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Country | US
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Telephone | 248-759-4852
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Fax | 248-299-9860
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | DR. JINSON JOSE
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Credential | MD
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Telephone | 248-299-9850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301085938
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License Number State | MI
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