MEDICARE: SDP GROUP 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
1	341600000X	Ambulance	821055	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1972788172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SDP GROUP INC.

Provider Business Mailing Address
First Line	:	28111 NORTHLINE RD
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-2829
Country	:	US
Telephone Number	:	734-946-4008
Fax Number	:	734-946-4872

Provider Business Practice Location Address
First Line	:	28111 NORTHLINE RD
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-2829
Country	:	US
Telephone Number	:	734-946-4008
Fax Number	:	734-946-4872

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL TALLEY
Credential	:
Telephone Number	:	734-946-4008

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	06/24/2008

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Directions to “SDP GROUP INC. ” Practice Location

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