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General NPI Number Information
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NPI Number | 1588850135
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Entity Type | Organization
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Legal Business Name | ASSOCIATED INTERNISTS PC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 26206 W 12 MILE RD STE 300A
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1754
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Country | US
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Telephone | 248-358-1000
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Fax | 248-358-1083
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Provider Business Mailing Address
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Address Line | 26206 W 12 MILE RD STE 300A
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1754
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Country | US
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Telephone | 248-358-1000
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Fax | 248-358-1083
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY H LEVY
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Credential | MD
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Telephone | 248-358-1000
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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 | 4301021081
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License Number State | MI
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