# HOME CLINIC PC

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

## Provider details

- **NPI number:** 1962645689
- **Authorized official:** PAUL PETRE MD (PRESIDENT)
- **Authorized official phone:** (248) 909-9494

## Contact information

- **Practice address:** 23999 NORTHWESTERN HWY, SUITE 110, SOUTHFIELD, MI 48075-2578
- **Practice address phone:** (248) 909-9494
- **Mailing address:** 23999 NORTHWESTERN HWY, SUITE 110, SOUTHFIELD, MI 48075-2578
- **Mailing address phone:** (248) 909-9494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2009
- **Last updated:** 09/24/2010