Organization Name: | DOWNRIVER INTERNISTS,P.C. |
NPI Number: | 1043352784 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BEVERLY JEAN SMITH (PRACTICE MANAGER) |
Mailing Address: | 7445 Allen Rd Suite 210 Allen Park |
State: | MI US |
Postal Code: | 481011963 |
Phone Number: | 3133820505 |
Fax Number: | 3133821584 |
NPI Enumeration Date: | 02/12/2007 |
NPI Last Update Date: | 01/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 001424 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |