Organization
PHYSICAL MEDICINE& REHABILITATION CONSULTANT AND PAIN MANAGEMENT,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWIT TEKLEHAIMANOT D.O. (PHYSICIAN)
(734) 717-3816
Entity
Organization
Contact information
Practice address
21675 COOLIDGE HWY, STE A, OAK PARK, MI 48237-3171
(248) 546-3467
(248) 546-3477
Mailing address
21675 COOLIDGE HWY, STE A, OAK PARK, MI 48237-3171
(248) 546-3467
(248) 546-3477
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
5101011761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4493556
—
MI
Enumeration date
03/20/2008
Last updated
11/05/2015
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