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NPI Code Detail

MEDICARE: MOBILE MEDICAL DOCTORS INC

MEDICARE: MOBILE MEDICAL DOCTORS INC
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 Physician
2208D00000XGeneral Practice PhysicianMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285729665
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE MEDICAL DOCTORS INC
Provider Business Mailing Address
First Line : 15819 SCHOOLCRAFT
Second Line :
City : DETROIT
State : MI
Zip : 48227-1749
Country : US
Telephone Number : 313-272-0200
Fax Number : 313-493-4904
Provider Business Practice Location Address
First Line : 15819 SCHOOLCRAFT
Second Line :
City : DETROIT
State : MI
Zip : 48227-1749
Country : US
Telephone Number : 313-272-0200
Fax Number : 313-493-4904
Authorized Official
Title or Position : CEO/OWNER
Name : MR. ROBERT E MCPHERSON
Credential :
Telephone Number : 313-272-0200
Provider Enumeration Date : 10/03/2006
Last Update Date : 11/17/2015

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Directions to “MOBILE MEDICAL DOCTORS INC ” Practice Location

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