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General NPI Number Information
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NPI Number | 1912062241
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Entity Type | Organization
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Legal Business Name | MARIA ADELMA PUNO, MD PLC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5770 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1877
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Country | US
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Telephone | 248-674-0388
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Fax | 248-674-0651
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Provider Business Mailing Address
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Address Line | PO BOX 32588
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City | DETROIT
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State | MI
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Zip | 48232-0588
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Country | US
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Telephone | 248-674-0388
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Fax | 248-674-0651
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Authorized Official
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Title or Position | OWNER
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Name | MARIA ADELMA PUNO
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Credential | MD
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Telephone | 248-674-0388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MP079587
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License Number State | MI
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