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General NPI Number Information
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NPI Number | 1992086680
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FAMILY HEALTHCARE PLLC
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 6770 DIXIE HWY STE 202
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City | CLARKSTON
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State | MI
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Zip | 48346-2087
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Country | US
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Telephone | 248-620-0377
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Fax | 248-620-0385
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Provider Business Mailing Address
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Address Line | 6770 DIXIE HWY STE 202
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City | CLARKSTON
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State | MI
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Zip | 48346-2087
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Country | US
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Telephone | 248-620-0377
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Fax | 248-620-0385
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Authorized Official
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Title or Position | OWNER
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Name | DR. THEODORE G ENGELMANN
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Credential | DO
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Telephone | 24862003777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | TE007018
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TE007018
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License Number State | MI
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