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General NPI Number Information
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NPI Number | 1659558153
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Entity Type | Organization
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Legal Business Name | SPECIALIST HOME CARE DOCTORS, P.C.
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 25929 CLARK ST
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City | NOVI
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State | MI
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Zip | 48375-1622
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Country | US
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Telephone | 248-349-2908
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Fax | 248-349-2908
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Provider Business Mailing Address
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Address Line | 25929 CLARK ST
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City | NOVI
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State | MI
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Zip | 48375-1622
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Country | US
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Telephone | 248-225-4600
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Fax | 248-349-2908
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERARDO FELICIANO
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Credential | M.D.
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Telephone | 248-225-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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