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General NPI Number Information
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NPI Number | 1578777165
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Entity Type | Organization
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Legal Business Name | BIRMINGHAM MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 306 TOWN CENTER DR
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City | TROY
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State | MI
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Zip | 48084-1742
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Country | US
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Telephone | 248-720-0277
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Fax | 248-720-0276
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Provider Business Mailing Address
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Address Line | 306 TOWN CENTER DR
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City | TROY
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State | MI
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Zip | 48084-1742
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Country | US
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Telephone | 248-720-0277
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Fax | 248-720-0276
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Authorized Official
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Title or Position | PHYSICIAN'S ASSISTANT
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Name | LISA SOWELS
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Credential | PA-C
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Telephone | 248-720-0277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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