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Organization
RENOVIS CHOICE COMPANY
Active
Organization
RENOVIS CHOICE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLISAELOKA DALLAH (CAO)
(248) 470-7318
Entity
Organization
Contact information
Practice address
25433 SAINT JAMES, SOUTHFIELD, MI 48075-1287
(248) 470-7318
Mailing address
19785 W 12 MILE RD STE 568, SOUTHFIELD, MI 48076-2584
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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