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General NPI Number Information
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NPI Number | 1326428285
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Entity Type | Organization
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Legal Business Name | IPC HOSPITALIST COMPANY
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 1628 HUNTWOOD PARK CT
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48324-3998
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Country | US
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Telephone | 313-530-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 1628 HUNTWOOD PARK CT
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48324-3998
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Country | US
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Telephone | 313-530-9188
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MELODY SHAW
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Credential | PA-C
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Telephone | 313-530-9188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 5601004921
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License Number State | MI
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