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General NPI Number Information
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NPI Number | 1407510829
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Entity Type | Organization
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Legal Business Name | WHOLE HEALTH INTEGRATIVE MEDICINE OF MICHIGAN, PLLC
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 210 W UNIVERSITY DR STE 6
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City | ROCHESTER
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State | MI
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Zip | 48307-1975
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Country | US
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Telephone | 248-692-4006
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Fax | 833-974-2235
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Provider Business Mailing Address
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Address Line | 210 W UNIVERSITY DR STE 6
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City | ROCHESTER
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State | MI
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Zip | 48307-1975
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Country | US
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Telephone | 248-692-4006
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Fax | 833-974-2235
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Authorized Official
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Title or Position | CO-OWNER
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Name | SIMONE COWAN
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Credential | DO
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Telephone | 248-692-4006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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