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General NPI Number Information
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NPI Number | 1437572930
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Entity Type | Organization
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Legal Business Name | INFINITY VISITING PHYSICIAN SERVICES PLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 18000 W 9 MILE RD STE 630
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4009
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Country | US
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Telephone | 313-757-7228
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Fax | 248-671-0175
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Provider Business Mailing Address
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Address Line | 18000 W 9 MILE RD STE 630
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4009
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Country | US
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Telephone | 313-757-7228
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Fax | 248-671-0175
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Authorized Official
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Title or Position | PRESIDENT
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Name | RADWAN MALAS
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Credential |
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Telephone | 248-854-5357
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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 | 4301078637
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License Number State | MI
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