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General NPI Number Information
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NPI Number | 1710163860
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Entity Type | Organization
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Legal Business Name | MEADOWBROOK INTERNISTS P C
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 2370 WALTON BLVD STE. 1
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1471
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Country | US
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Telephone | 248-601-9200
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Fax | 248-601-9937
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Provider Business Mailing Address
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Address Line | 75 BARCLAY CIRCLE SUITE 230
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5823
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Country | US
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Telephone | 248-856-6600
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Fax | 248-856-6601
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ALICE CAVAIANI
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Credential |
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Telephone | 248-856-6600
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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 |
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License Number State | MI
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