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General NPI Number Information
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NPI Number | 1790010544
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Entity Type | Organization
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Legal Business Name | IGNATIOS VOUDOUKIS MD PC
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 4727 SAINT ANTOINE ST SUITE 402
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City | DETROIT
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State | MI
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Zip | 48201-1461
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Country | US
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Telephone | 313-831-4600
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Fax | 313-831-1220
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Provider Business Mailing Address
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Address Line | 4727 SAINT ANTOINE ST SUITE 402
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City | DETROIT
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State | MI
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Zip | 48201-1461
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Country | US
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Telephone | 313-831-4600
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Fax | 313-831-1220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IGNATIOS VOUDOUKIS
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Credential | MD
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Telephone | 313-831-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301028811
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License Number State | MI
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