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General NPI Number Information
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NPI Number | 1831342914
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Entity Type | Organization
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Legal Business Name | HOME VISITING DOCTORS, PLLC
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 23100 PROVIDENCE DR STE # 152
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3646
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Country | US
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Telephone | 248-327-4523
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Fax | 248-443-7109
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Provider Business Mailing Address
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Address Line | 23100 PROVIDENCE DR STE # 152
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3646
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Country | US
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Telephone | 248-327-4523
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Fax | 248-443-7109
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE A MERCADO-FRANCIS
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Credential | M.D.
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Telephone | 248-327-4523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 4301078684
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License Number State | MI
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