Organization
C & M VISITING PHYSICIANS PLC
Active
Other names
homecare doctors llc
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MCRAE (ADMINISTRATOR)
(313) 874-4436
Entity
Organization
Contact information
Practice address
2990 W GRAND BLVD, SUITE 408, DETROIT, MI 48202-3041
(313) 874-4436
Mailing address
2990 W GRAND BLVD, SUITE 408, DETROIT, MI 48202-3041
(313) 874-4436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H211060
BLUE CROSS BLUE SHIELD
MI
01
—
1144240458
JOHN MCCOLLOUGH MD
MI
01
—
1770553521
ALPHONSO BERRY MD
MI
Enumeration date
11/08/2006
Last updated
03/12/2009
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