Organization
GREAT LAKES VISITING PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR SAVINOV M.D. (PRESIDENT)
(734) 709-3319
Entity
Organization
Contact information
Practice address
10 N HEWITT RD, STE 2, YPSILANTI, MI 48197-4496
(734) 709-3319
(734) 212-1541
Mailing address
10 N HEWITT RD., STE 2, YPSILANTI, MI 48197-4496
(734) 709-3319
(734) 212-1541
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4301057059
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106369221
BLUE CROSS BLUE SHEILD
MI
Enumeration date
01/09/2012
Last updated
01/18/2012
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