# PHYSICIANS RESIDENTIAL SERVICES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700866811
- **Authorized official:** DR. EDWIN J SOLER-VALCOURT M.D. (PRESIDENT)
- **Authorized official phone:** (586) 777-8801

## Contact information

- **Practice address:** 20927 KELLY RD, EASTPOINTE, MI 48021-3128
- **Practice address phone:** (586) 777-8801
- **Practice address fax:** (586) 777-9988
- **Mailing address:** 20927 KELLY RD, EASTPOINTE, MI 48021-3128
- **Mailing address phone:** (586) 777-8801
- **Mailing address fax:** (586) 777-9988

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 4301068676 | MI | Yes |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 12/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 010066340 | RAILROAD MEDICARE | — |
| 01 | — | 010E010070 | BCBSM | — |
| 05 | — | 104676117 | — | MI |
| 05 | — | 104784286 | — | MI |
| 05 | — | 135198828 | — | MI |
| 01 | — | P00298680 | RAILROAD MEDICARE | — |
| 01 | — | P00405274 | RAILROAD MEDICARE | — |