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General NPI Number Information
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NPI Number | 1417961673
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Entity Type | Individual
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Provider Name | RICHARD F NIMBACH D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1101 W UNIVERSITY DR
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City | ROCHESTER
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State | MI
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Zip | 48307-1863
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Country | US
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Telephone | 248-652-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 591 S SPINNINGWHEEL LN
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-1321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 5101005937
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License Number State | MI
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