Organization
PHYSICIANS RESIDENTIAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN J SOLER-VALCOURT M.D. (PRESIDENT)
(586) 777-8801
Entity
Organization
Contact information
Practice address
20927 KELLY RD, EASTPOINTE, MI 48021-3128
(586) 777-8801
(586) 777-9988
Mailing address
20927 KELLY RD, EASTPOINTE, MI 48021-3128
(586) 777-8801
(586) 777-9988
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301068676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010066340
RAILROAD MEDICARE
—
01
—
010E010070
BCBSM
—
05
—
104676117
—
MI
05
—
104784286
—
MI
05
—
135198828
—
MI
01
—
P00298680
RAILROAD MEDICARE
—
01
—
P00405274
RAILROAD MEDICARE
—
Enumeration date
01/17/2006
Last updated
12/15/2011
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