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General NPI Number Information
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NPI Number | 1790785095
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Entity Type | Organization
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Legal Business Name | SOUTHFIELD REHABILITATION COMPANY
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 22401 FOSTER WINTER DRIVE
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3724
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Country | US
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Telephone | 248-423-5100
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Fax | 248-423-5199
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Provider Business Mailing Address
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Address Line | PO BOX 674073
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City | DETROIT
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State | MI
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Zip | 48267-4073
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Country | US
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Telephone | 586-582-0864
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Fax | 586-576-0393
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONDA F SELEY
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Credential | D.O.
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Telephone | 248-423-5198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 630013
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 630013
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License Number State | MI
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