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General NPI Number Information
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NPI Number | 1689875726
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Entity Type | Organization
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Legal Business Name | LIVERNOIS CLINIC, P.C.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 17330 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3158
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Country | US
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Telephone | 734-425-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 17330 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3158
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Country | US
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Telephone | 734-425-2626
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SION SOLEYMANI
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Credential | M D
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Telephone | 313-838-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | SS0269894
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License Number State | MI
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