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General NPI Number Information
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NPI Number | 1407747215
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Entity Type | Organization
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Legal Business Name | HOME MD PLLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 4568 W WALTON BLVD STE D
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City | WATERFORD
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State | MI
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Zip | 48329-4900
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Country | US
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Telephone | 855-466-3631
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Fax | 833-973-4493
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Provider Business Mailing Address
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Address Line | 4568 W WALTON BLVD STE D
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City | WATERFORD
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State | MI
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Zip | 48329-4900
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Country | US
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Telephone | 855-466-3631
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Fax | 833-973-4493
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBORAH VAUBEL
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Credential |
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Telephone | 810-620-0398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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