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General NPI Number Information
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NPI Number | 1194050005
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Entity Type | Individual
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Provider Name | WILLIAM ADAM BELUZO III RN
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Gender | Male
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 10001 PURITAN ST
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City | DETROIT
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State | MI
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Zip | 48238-1056
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Country | US
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Telephone | 313-961-4722
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Fax | 313-494-4120
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Provider Business Mailing Address
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Address Line | 10001 PURITAN ST
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City | DETROIT
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State | MI
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Zip | 48238-1056
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Country | US
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Telephone | 313-961-4722
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Fax | 313-494-4120
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4704198931
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License Number State | MI
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