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General NPI Number Information
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NPI Number | 1417979360
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Entity Type | Organization
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Legal Business Name | NOVA MEDICA PLLC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 20331 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-1411
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Country | US
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Telephone | 248-478-1100
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Fax | 248-478-7054
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Provider Business Mailing Address
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Address Line | 20331 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-1411
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Country | US
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Telephone | 248-478-1100
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Fax | 248-478-7054
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. NASSER TAGHAVI
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Credential | MD
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Telephone | 248-478-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | NT060867
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License Number State | MI
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