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General NPI Number Information
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NPI Number | 1689169542
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Entity Type | Organization
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Legal Business Name | WARREN FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 06/24/2018
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Last Update Date | 06/24/2018
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Provider Practice Location Address
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Address Line | 26000 HOOVER RD STE 105
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City | WARREN
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State | MI
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Zip | 48089-1167
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Country | US
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Telephone | 586-722-0998
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Fax | 586-806-5347
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Provider Business Mailing Address
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Address Line | 26000 HOOVER RD STE 105
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City | WARREN
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State | MI
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Zip | 48089-1167
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Country | US
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Telephone | 586-722-0998
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Fax | 586-806-5347
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Authorized Official
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Title or Position | PHYSICAN/OWNER
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Name | DR. NORMAN SALEM
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Credential | MD
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Telephone | 248-904-7229
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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 | 4301108617
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License Number State | MI
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