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Organization
RENOVIS CARE COMPANY
Active
Organization
RENOVIS CARE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLISAELOKA I DALLAH (CHIEF ADMINISTRATIVE OFFICER)
(248) 470-7318
Entity
Organization
Contact information
Practice address
25433 SAINT JAMES, SOUTHFIELD, MI 48075
(248) 470-7318
Mailing address
29155 NORTHWESTERN HWY STE 515, SOUTHFIELD, MI 48034-1011
(248) 470-7318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
06/01/2023
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