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General NPI Number Information
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NPI Number | 1952573248
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Entity Type | Organization
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Legal Business Name | HOLY FAMILY CLINIC PLC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 502 E CUMMINS ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2074
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Country | US
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Telephone | 517-423-5508
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Fax | 517-423-4772
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Provider Business Mailing Address
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Address Line | 502 E CUMMINS ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2074
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Country | US
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Telephone | 517-423-5508
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Fax | 517-423-4772
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARIA ADELA ASIS CORDOBA-NAUGIT
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Credential | M.D.
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Telephone | 517-423-5508
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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 | 4301073146
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License Number State | MI
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