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General NPI Number Information
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NPI Number | 1265629315
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FAMILY MEDICAL
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 27144 JOY RD
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City | REDFORD
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State | MI
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Zip | 48239-2368
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Country | US
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Telephone | 313-937-1190
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Fax | 313-937-1077
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Provider Business Mailing Address
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Address Line | 27144 JOY RD
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City | REDFORD
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State | MI
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Zip | 48239-2368
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Country | US
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Telephone | 313-937-1190
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Fax | 313-937-1077
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Authorized Official
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Title or Position | PHYSICIAN
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Name | PATRICIA PIERCE
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Credential | DO
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Telephone | 313-937-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PP007761
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License Number State | MI
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