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General NPI Number Information
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NPI Number | 1669508917
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Entity Type | Organization
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Legal Business Name | HEALTH ONE MEDICAL CENTER, EASTPOINTE LLC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 04/15/2018
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Provider Practice Location Address
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Address Line | 21501 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3213
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Country | US
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Telephone | 586-776-4185
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Fax | 586-776-5132
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Provider Business Mailing Address
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Address Line | 21501 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3213
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Country | US
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Telephone | 586-776-4185
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Fax | 586-776-5132
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SATISH R MEHTA
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Credential | MD
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Telephone | 586-776-4185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301065258
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301065258
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License Number State | MI
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