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General NPI Number Information
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NPI Number | 1437806692
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Entity Type | Organization
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Legal Business Name | DR URSULA BARGHOUTH DO MHA MSPH CWSP
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 22250 PROVIDENCE DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4825
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Country | US
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Telephone | 248-849-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 44240 PRINCETON DR
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1095
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Country | US
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Telephone | 408-807-4504
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. URSULA BARGHOUTH
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Credential | DO, MHA, MSPH, CSWP
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Telephone | 408-807-4504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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