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General NPI Number Information
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NPI Number | 1295916880
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Entity Type | Organization
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Legal Business Name | VISITING HOME DOCTORS, PLLC
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Dates
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Enumeration Date | 11/24/2007
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Last Update Date | 11/24/2007
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Provider Practice Location Address
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Address Line | 17344 W 12 MILE RD SUITE #203B
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2121
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Country | US
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Telephone | 888-785-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 17344 W 12 MILE RD SUITE #203B
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2121
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Country | US
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Telephone | 888-785-9595
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | LUIS A NINO
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Credential | MD
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Telephone | 888-785-9595
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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 |
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License Number State |
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