# MY HOME DOCTORS PLLC

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

## Provider details

- **NPI number:** 1710250147
- **Authorized official:** MISS KELLY BOEKEMA (BOOKKEEPER)
- **Authorized official phone:** (586) 293-1868

## Contact information

- **Practice address:** 30140 HARPER AVE, SUITE 300, SAINT CLAIR SHORES, MI 48082-1610
- **Practice address phone:** (586) 359-6983
- **Practice address fax:** (586) 293-1869
- **Mailing address:** 30140 HARPER AVE, SUITE 300, SAINT CLAIR SHORES, MI 48082-1610
- **Mailing address phone:** (586) 359-6983
- **Mailing address fax:** (586) 293-1869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 4301088798 | MI | Yes |

## Other

- **Enumeration date:** 02/15/2012
- **Last updated:** 02/15/2012