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NPI Code Detail

MEDICARE: ENCORE GERIATRICS PLLC

MEDICARE: ENCORE GERIATRICS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician5101007865MI

General Provider Information

NPI Number : 1053811380
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENCORE GERIATRICS PLLC
Provider Business Mailing Address
First Line : PO BOX 2444
Second Line :
City : DALTON
State : GA
Zip : 30722-2444
Country : US
Telephone Number : 423-310-1642
Fax Number :
Provider Business Practice Location Address
First Line : 8365 N NEWBURGH RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-1149
Country : US
Telephone Number : 423-310-1642
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANDREW COLMAN
Credential : DO
Telephone Number : 423-310-1642
Provider Enumeration Date : 02/13/2018
Last Update Date : 08/30/2022

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Directions to “ENCORE GERIATRICS PLLC ” Practice Location

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