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General NPI Number Information
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NPI Number | 1992017412
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Entity Type | Organization
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Legal Business Name | TRINITY MEDICAL CASE MANAGEMENT, INC.
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 4490 GATEWAY CIR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3670
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Country | US
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Telephone | 248-557-5200
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Fax | 248-557-9076
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Provider Business Mailing Address
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Address Line | 4490 GATEWAY CIR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3670
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Country | US
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Telephone | 248-557-5200
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Fax | 248-557-9076
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Authorized Official
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Title or Position | OWNER
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Name | A B DURHAM
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Credential |
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Telephone | 248-557-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State | MI
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