MEDICARE: CITY OF DETROIT

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
1	251K00000X	Public Health or Welfare Agency
2	207RI0200X	Infectious Disease Physician

General Provider Information

NPI Number	:	1588974844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF DETROIT

Provider Business Mailing Address
First Line	:	1151 TAYLOR ST
Second Line	:	111C
City	:	DETROIT
State	:	MI
Zip	:	48202-1732
Country	:	US
Telephone Number	:	313-876-4717
Fax Number	:	313-876-0475

Provider Business Practice Location Address
First Line	:	3245 E JEFFERSON AVE STE 100
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4222
Country	:	US
Telephone Number	:	313-876-4000
Fax Number	:	313-876-0475

Authorized Official
Title or Position	:	SENIOR PUBLIC HEALTH ADVISOR
Name	:	DR. KANZONI ASABIGI
Credential	:
Telephone Number	:	313-876-4000

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	07/21/2022

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Directions to “CITY OF DETROIT ” Practice Location

Language	Start Address	Practice Location

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