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General NPI Number Information
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NPI Number | 1730193657
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Entity Type | Organization
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Legal Business Name | TRINITY MEDICAL CENTER, P.C.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 37300 DEQUINDRE RD SUITE 120
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-3591
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Country | US
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Telephone | 586-275-0065
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Fax | 586-275-0066
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Provider Business Mailing Address
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Address Line | 37300 DEQUINDRE RD STE 120
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-3591
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Country | US
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Telephone | 586-275-0065
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Fax | 586-275-0066
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. VICTOR PETROS AL-MATCHY
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Credential | M.D.
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Telephone | 586-275-0065
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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 | 4301070663
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License Number State | MI
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