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NPI Code Detail

MEDICARE: DOWNRIVER INTERNAL MEDICINE, PC

MEDICARE: DOWNRIVER INTERNAL MEDICINE, PC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1417160698
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOWNRIVER INTERNAL MEDICINE, PC
Provider Business Mailing Address
First Line : 14700 KING RD
Second Line : STE A
City : RIVERVIEW
State : MI
Zip : 48193-7909
Country : US
Telephone Number : 734-479-1944
Fax Number : 734-479-1253
Provider Business Practice Location Address
First Line : 14700 KING RD
Second Line : STE A
City : RIVERVIEW
State : MI
Zip : 48193-7909
Country : US
Telephone Number : 734-479-1944
Fax Number : 734-479-1253
Authorized Official
Title or Position : OFFICE MANAGER
Name : LYNETTE HINDS
Credential :
Telephone Number : 734-479-1944
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/06/2010

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Directions to “DOWNRIVER INTERNAL MEDICINE, PC ” Practice Location

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