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General NPI Number Information
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NPI Number | 1285995134
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR POPULATION HEALTH INC.
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 1151 TAYLOR ST
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 TAYLOR ST
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-0475
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/HEALTH OFFICER
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Name | LORETTA V. DAVIS
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Credential |
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Telephone | 313-876-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State | MI
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