Doctor Name: | MR. BERTRAM N NWAOPARA |
NPI Number: | 1356494827 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 5398880001 |
Business Practice Address: | 34741 Grand River Ave Farmington, MI - 483353315 |
Business Phone Number: | 2484714669 |
Business Fax Number: | 2484714899 |
Mailing Address: | 34741 Grand River Ave, FARMINGTON |
State: | MI |
Postal Code: | 483353315 |
Phone Number: | 2484714669 |
Fax Number: | 2484714899 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 08/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 5398880001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |