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General NPI Number Information
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NPI Number | 1174838890
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Entity Type | Organization
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Legal Business Name | TETE ONIANG'O M.D. PLLC
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 20526 PLYMOUTH RD SUITE E
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City | DETROIT
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State | MI
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Zip | 48228-1201
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Country | US
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Telephone | 313-397-9085
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 760395
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-0395
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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 | PRESIDENT
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Name | TETE ONIANG'O
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Credential |
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Telephone | 313-397-9085
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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 | 4301091134
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License Number State | MI
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