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General NPI Number Information
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NPI Number | 1467217273
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PLUS, PLLC
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 38900 CHERRY HILL RD
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City | WESTLAND
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State | MI
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Zip | 48185-3239
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Country | US
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Telephone | 734-895-3967
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Fax | 734-888-2328
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Provider Business Mailing Address
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Address Line | 38900 CHERRY HILL RD
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City | WESTLAND
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State | MI
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Zip | 48185-3239
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Country | US
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Telephone | 734-895-3967
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Fax | 734-888-2328
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. LATOYA SHEVELL RICHARDSON
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Credential | NP
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Telephone | 313-522-0311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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