Organization
PLATINUM CARE PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AQUARIUS BOUIER (MANAGER)
(248) 967-3200
Entity
Organization
Contact information
Practice address
27207 LAHSER RD, SUITE 250, SOUTHFIELD, MI 48034-2168
(248) 967-3200
(248) 967-1387
Mailing address
27207 LAHSER RD, SUITE 250, SOUTHFIELD, MI 48034-2168
(248) 967-3200
(248) 967-1387
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
5101007369
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
5101012320
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H71585
BCBSM PIN/FACILITY CODE
MI
Enumeration date
10/02/2014
Last updated
06/23/2015
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