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NPI 1659519981

NPI 1659519981 : VISITING DOCTORS FOR AMERICA PC : DEARBORN HEIGHTS, MI

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General NPI Number Information
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    NPI Number           |    1659519981
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    Entity Type          |    Organization 
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    Legal Business Name  |    VISITING DOCTORS FOR AMERICA PC 
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Dates
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    Enumeration Date     |    01/23/2009
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    Last Update Date     |    01/23/2009
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Provider Practice Location Address
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    Address Line         |    6000 N WAVERLY ST 
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    City                 |    DEARBORN HEIGHTS
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    State                |    MI
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    Zip                  |    48127-3227
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    Country              |    US
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    Telephone            |    313-671-6549
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6000 N WAVERLY ST 
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    City                 |    DEARBORN HEIGHTS
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    State                |    MI
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    Zip                  |    48127-3227
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    Country              |    US
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    Telephone            |    313-671-6549
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MS. FATIMA  MALIK 
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    Credential           |    
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    Telephone            |    313-671-6549
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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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