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Organization
THEORIA MEDICAL
Active
Organization
THEORIA MEDICAL
Active
Other names
Theoria Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DI REZZE MD (CEO)
(313) 610-8402
Entity
Organization
Contact information
Practice address
6247 GRAND RIVER RD STE 400, BRIGHTON, MI 48114-5326
(810) 215-7177
(313) 217-3334
Mailing address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/27/2021
Last updated
06/26/2026
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