| Visiting Physicians Of Detroit Pllc | |
|
17330 Northland Park Ct Ste 200 Southfield MI 48075-4318 | |
| (248) 552-9500 | |
| Not Available |
| Full Name | Visiting Physicians Of Detroit Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17330 Northland Park Ct Ste 200, Southfield, Michigan |
| Authorized Official Name and Position | Leonard Ellison (OWNER) |
| Authorized Official Contact | 3133085120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visiting Physicians Of Detroit Pllc 1800 Iroquois St Detroit MI 48214-2748 Ph: () - | Visiting Physicians Of Detroit Pllc 17330 Northland Park Ct Ste 200 Southfield MI 48075-4318 Ph: (248) 552-9500 |
| NPI Number | 1568185833 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 09/22/2022 |
| Medicare PECOS PAC ID | 4284001355 |
|---|---|
| Medicare Enrollment ID | O20221102000783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568185833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Leonard Ellison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679575328 PECOS PAC ID: 5395631188 Enrollment ID: I20040227000124 |
| Provider Name | Shelandra Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215245873 PECOS PAC ID: 6002035433 Enrollment ID: I20160906000596 |
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