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General NPI Number Information
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NPI Number | 1528152246
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA MANAGEMENT CENTER PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 26850 PROVIDENCE PKWY SUITE 310
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City | NOVI
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State | MI
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Zip | 48374-1209
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Country | US
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Telephone | 248-380-9630
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Fax | 248-380-3459
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Provider Business Mailing Address
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Address Line | 26850 PROVIDENCE PKWY SUITE 310
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City | NOVI
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State | MI
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Zip | 48374-1209
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Country | US
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Telephone | 248-380-9630
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Fax | 248-380-3459
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROLA BOKHARI PANZA
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Credential | MD
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Telephone | 248-478-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | RB069790
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License Number State | MI
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