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General NPI Number Information
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NPI Number | 1619948114
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE CENTRE OF LIVONIA, PC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 38253 ANN ARBOR RD
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City | LIVONIA
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State | MI
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Zip | 48150-3432
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Country | US
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Telephone | 734-464-9200
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Fax | 734-464-0017
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Provider Business Mailing Address
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Address Line | 38253 ANN ARBOR RD
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City | LIVONIA
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State | MI
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Zip | 48150-3432
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Country | US
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Telephone | 734-464-9200
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Fax | 734-464-0017
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Authorized Official
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Title or Position | PARTNER
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Name | TROY MERRILL SMITH
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Credential | DO
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Telephone | 734-464-9200
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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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