Organization Name: | VERNOR MC INC |
NPI Number: | 1871720342 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ZULMA ALLENDE (PRESIDENT) |
Mailing Address: | 5705 W Vernor Hwy Detroit |
State: | MI US |
Postal Code: | 482092157 |
Phone Number: | 3138410395 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2009 |
NPI Last Update Date: | 06/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |