Organization Name: | BI-COUNTY HEALTH CARE PC |
NPI Number: | 1023287356 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIRANMAYI SURAPANENI (MEMBER) |
Mailing Address: | 116 W 8 Mile Rd Hazel Park |
State: | MI US |
Postal Code: | 480302433 |
Phone Number: | 2485417606 |
Fax Number: | 2485417197 |
NPI Enumeration Date: | 02/20/2008 |
NPI Last Update Date: | 03/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 4301080888 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |