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General NPI Number Information
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NPI Number | 1689863870
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Entity Type | Organization
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Legal Business Name | HAROLD JOH, MD.PC
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 1547 S WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48186-5436
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Country | US
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Telephone | 734-729-3133
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Fax | 734-729-3130
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Provider Business Mailing Address
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Address Line | 1547 S WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48186-5436
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Country | US
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Telephone | 734-729-3133
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Fax | 734-729-3130
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROLD JOH
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Credential | M.D.
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Telephone | 734-729-3133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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