Organization
MY VISITING PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN AGBEBIYI M.D. (OWNER)
(248) 946-2050
Entity
Organization
Contact information
Practice address
20755 GREENFIELD RD, SUITE 100A, SOUTHFIELD, MI 48075
(248) 946-2050
Mailing address
20755 GREENFIELD RD, SUITE 100A, SOUTHFIELD, MI 48075
(248) 946-2050
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
4301041053
MI
207V00000X
Obstetrics & Gynecology Physician
4301041053
MI
208D00000X
General Practice Physician
Primary
4301041053
MI
Other
Enumeration date
02/09/2010
Last updated
04/29/2011
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