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General NPI Number Information
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NPI Number | 1568519395
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Entity Type | Organization
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Legal Business Name | WESTLAND QUALITY HEALTHCARE PC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 35180 NANKIN BLVD SUITE 200
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City | WESTLAND
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State | MI
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Zip | 48185-2092
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Country | US
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Telephone | 734-261-0005
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Fax | 734-466-8567
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Provider Business Mailing Address
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Address Line | 35180 NANKIN BLVD SUITE 200
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City | WESTLAND
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State | MI
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Zip | 48185-2092
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Country | US
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Telephone | 734-261-0005
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Fax | 734-466-8567
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PRABHA B MOHTA
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Credential | M.D.
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Telephone | 734-261-0005
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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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