Organization
LIVONIA DIAGNOSTIC CENTER,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE L EVANGELISTA M.D. (M.D.)
(734) 427-9440
Entity
Organization
Contact information
Practice address
10475 FARMINGTON RD, LIVONIA, MI 48150-5704
(734) 427-9440
(734) 427-1701
Mailing address
10475 FARMINGTON RD, LIVONIA, MI 48150-5704
(734) 427-9440
(734) 427-1701
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4301031560
MI
Other
Enumeration date
05/17/2007
Last updated
05/25/2010
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