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General NPI Number Information
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NPI Number | 1902123904
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Entity Type | Organization
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Legal Business Name | NINUL INC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 637 E BIG BEAVER RD
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City | TROY
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State | MI
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Zip | 48083-1423
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Country | US
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Telephone | 248-525-5314
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Fax | 877-353-2634
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Provider Business Mailing Address
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Address Line | 23679 CALABASAS RD STE 784
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City | CALABASAS
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State | CA
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Zip | 91302-1502
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Country | US
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Telephone | 248-525-5314
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Fax | 877-353-2634
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Authorized Official
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Title or Position | FAMILY PRACTICE/PLASTIC SURGERY
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Name | DR. VICTOR ABIRAGI
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Credential | M.D.,
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Telephone | 248-525-5314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number |
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License Number State |
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