Organization
FIRST IDEAL ENTERPRISES INC.
Active
Other names
Ideal Home Physicians PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEKUNLE EMMANUEL OSHIYOYE M.D. (CEO)
(248) 440-0920
Entity
Organization
Contact information
Practice address
21700 NORTHWESTERN HWY, SUITE 801, SOUTHFIELD, MI 48075-4906
(248) 440-0920
(248) 440-0929
Mailing address
PO BOX 251062, W BLOOMFIELD, MI 48325-1062
(248) 440-0920
(248) 440-0929
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
AO060924
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F33532
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/10/2007
Last updated
04/22/2009
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