Organization
ALPHA PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM CHARLES DESANO (ADMINISTRATOR)
(734) 250-7377
Entity
Organization
Contact information
Practice address
30808 ISLAND DR, GIBRALTAR, MI 48173-9547
(734) 250-7377
(734) 284-6889
Mailing address
30808 ISLAND DR, GIBRALTAR, MI 48173-9547
(734) 250-7377
(734) 284-6889
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP53240
PTAN
MI
Enumeration date
12/04/2007
Last updated
07/21/2022
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