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General NPI Number Information
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NPI Number | 1942392535
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Entity Type | Organization
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Legal Business Name | RAINA ERNSTOFF, M.D.P.C.
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3535 W 13 MILE RD SUITE 747
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City | ROYAL OAK
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State | MI
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Zip | 48073-6710
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Country | US
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Telephone | 248-435-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 W 13 MILE RD SUITE 747
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City | ROYAL OAK
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State | MI
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Zip | 48073-6710
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Country | US
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Telephone | 248-435-5700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAINA ERNSTOFF
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Credential | M.D.
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Telephone | 248-435-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301030316
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License Number State | MI
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