Organization
CITY OF DETROIT
Active
Other names
Detroit Health Dept-Maternal Support Service
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONEIGH KHALDUN MD (MEDICAL DIRECTOR)
(313) 876-4000
Entity
Organization
Contact information
Practice address
3245 E JEFFERSON AVE STE 100, DETROIT, MI 48207-4222
(313) 876-4000
Mailing address
1151 TAYLOR ST, BUIDING #6, DETROIT, MI 48202-1732
(313) 876-4161
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1849879
—
MI
Enumeration date
12/10/2007
Last updated
07/21/2022
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