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General NPI Number Information
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NPI Number | 1740683176
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PATIENT CARE PC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 901 W GRAND BLVD SUITE 101
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City | DETROIT
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State | MI
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Zip | 48208-2353
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Country | US
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Telephone | 313-894-1500
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Fax | 313-894-1501
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Provider Business Mailing Address
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Address Line | 901 W GRAND BLVD SUITE 101
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City | DETROIT
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State | MI
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Zip | 48208-2353
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Country | US
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Telephone | 313-894-1500
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Fax | 313-894-1501
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Authorized Official
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Title or Position | CEO
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Name | MEIUTTENUN BROWN
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Credential | M.D
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Telephone | 586-275-2028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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