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General NPI Number Information
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NPI Number | 1609699842
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Entity Type | Organization
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Legal Business Name | PREFERRED MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 5575 CONNER ST STE 203
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City | DETROIT
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State | MI
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Zip | 48213-6401
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Country | US
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Telephone | 313-305-4210
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Fax | 313-305-7336
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Provider Business Mailing Address
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Address Line | 143 CADYCENTRE UNIT 151
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City | NORTHVILLE
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State | MI
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Zip | 48167-1119
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Country | US
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Telephone | 313-850-6549
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | ROCELIOUS GOODSON III
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Credential | PA-C
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Telephone | 313-305-4210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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