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NPI Code Detail

MEDICARE: EXCLUSIVE PHYSICIANS GROUP, PLLC

MEDICARE: EXCLUSIVE PHYSICIANS GROUP, 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
1174400000XSpecialistB2895AMI

General Provider Information

NPI Number : 1558439141
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCLUSIVE PHYSICIANS GROUP, PLLC
Provider Business Mailing Address
First Line : PO BOX 44047
Second Line :
City : DETROIT
State : MI
Zip : 48244-0047
Country : US
Telephone Number : 248-544-6236
Fax Number : 248-544-4681
Provider Business Practice Location Address
First Line : 911 E 9 MILE RD
Second Line :
City : FERNDALE
State : MI
Zip : 48220-1934
Country : US
Telephone Number : 248-544-6236
Fax Number : 248-544-4681
Authorized Official
Title or Position : CEO MEDICAL DIRECTOR
Name : DR. GREG NAMAN
Credential : MD
Telephone Number : 248-545-7210
Provider Enumeration Date : 12/01/2006
Last Update Date : 08/22/2020

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