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General NPI Number Information
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NPI Number | 1447438759
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Entity Type | Organization
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Legal Business Name | YOUR PHYSICIANS P.C.
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 1135 W UNIVERSITY DR SUITE 220
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1871
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Country | US
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Telephone | 248-651-1155
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Fax | 248-651-8537
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Provider Business Mailing Address
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Address Line | 1135 W UNIVERSITY DR SUITE 220
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1871
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Country | US
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Telephone | 248-651-1155
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Fax | 248-651-8537
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATIE SHORT
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Credential |
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Telephone | 248-651-1155
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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 | 4301074932
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License Number State | MI
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