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General NPI Number Information
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NPI Number | 1194042176
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Entity Type | Organization
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Legal Business Name | NOVI HEALTH CENTER P C
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 39575 W 10 MILE RD STE 205
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City | NOVI
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State | MI
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Zip | 48375-2949
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Country | US
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Telephone | 248-477-4411
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Fax | 248-477-4413
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Provider Business Mailing Address
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Address Line | 39575 W 10 MILE RD STE 205
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City | NOVI
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State | MI
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Zip | 48375-2949
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Country | US
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Telephone | 248-477-4411
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Fax | 248-477-4413
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY C WOOD
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Credential | MD
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Telephone | 248-477-4411
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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 | 4301032978
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License Number State | MI
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