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Organization

S.P.O.R.T. PHYSICIANS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JOYCE HOEY (OFFICE MANAGER)
(248) 528-0050
Entity
Organization

Contact information

Practice address
1950 E WATTLES RD, SUITE 110, TROY, MI 48085-5099
(248) 528-0050
(248) 528-0909
Mailing address
1950 E WATTLES RD, SUITE 110, TROY, MI 48085-5099
(248) 528-0050
(248) 528-0909

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301046108
MI
174400000X
Specialist
4301406072
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
250F312460
BCBS OF MICHIGAN
MI
Enumeration date
12/04/2006
Last updated
04/28/2008
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