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General NPI Number Information
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NPI Number | 1730621723
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Entity Type | Organization
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Legal Business Name | MICHIGAN SINUS AND SKULL INSTITUTE PLLC
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 4100 JOHN R ST WERTZ CANCER CLINIC
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City | DETROIT
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State | MI
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Zip | 48201-2013
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Country | US
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Telephone | 313-745-5111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1792
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City | BIRMINGHAM
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State | MI
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Zip | 48012-1792
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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 | DOCTOR
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Name | ADAM FOLBE
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Credential | MD
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Telephone | 248-842-7082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301078307
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License Number State | MI
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