Organization
HOME VISIT MD PLC
Active
Other names
HOME VISIT M.D., PLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD N EBURUCHE SR. MD (OWNER)
(248) 440-6090
Entity
Organization
Contact information
Practice address
26206 W 12 MILE RD, STE 302, SOUTHFIELD, MI 48034-8501
(248) 440-6090
(248) 440-6094
Mailing address
P. O. BOX 250077, FRANKLIN, MI 48025
(248) 440-6090
(248) 440-6094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080385
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470773210
—
MI
Enumeration date
03/01/2007
Last updated
03/09/2016
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