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General NPI Number Information
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NPI Number | 1720149891
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Entity Type | Organization
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Legal Business Name | MITCHELL H FOLBE MD
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 E LONG LAKE RD
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City | TROY
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State | MI
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Zip | 48085-5524
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Country | US
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Telephone | 248-879-2500
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Fax | 248-879-2997
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Provider Business Mailing Address
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Address Line | 115 E LONG LAKE RD
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City | TROY
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State | MI
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Zip | 48085-5524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MITCHELL FORBE
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Credential |
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Telephone | 248-879-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 4301059575
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License Number State | MI
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