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General NPI Number Information
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NPI Number | 1427476431
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Entity Type | Organization
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Legal Business Name | HEALTH HEROES OF MICHIGAN INC
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 2723 S STATE ST STE 150147
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City | ANN ARBOR
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State | MI
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Zip | 48104-6188
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Country | US
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Telephone | 334-558-5446
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 S STATE ST STE 150147
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City | ANN ARBOR
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State | MI
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Zip | 48104-6188
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Country | US
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Telephone | 334-558-5446
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Fax |
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Authorized Official
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Title or Position | PARTNER/CEO
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Name | SANDRA PORTER-DI SALVO
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Credential |
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Telephone | 256-426-5389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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