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General NPI Number Information
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NPI Number | 1811650435
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Entity Type | Organization
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Legal Business Name | NOD-PRIME RHEUMATOLOGY SPECIALISTS PLLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1623 FORD AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192-2303
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Country | US
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Telephone | 734-389-7167
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 E CAMELBACK RD STE 600
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City | PHOENIX
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State | AZ
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Zip | 85016-3493
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Country | US
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Telephone | 602-714-8162
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Fax |
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Authorized Official
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Title or Position | EVP
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Name | BRANDI CONNER
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Credential |
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Telephone | 602-714-8162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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