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General NPI Number Information
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NPI Number | 1598825440
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Entity Type | Organization
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Legal Business Name | CITY OF DETROIT
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3245 E JEFFERSON AVE STE 100
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City | DETROIT
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State | MI
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Zip | 48207-4222
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Country | US
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Telephone | 313-876-4710
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Fax | 313-876-0177
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Provider Business Mailing Address
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Address Line | 1151 TAYLOR ST ROOM 349C
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-4710
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Fax | 313-876-0177
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JONEIGH KHALDUN
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Credential | MD
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Telephone | 313-876-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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