Organization
MICHIGAN HOSPITAL PHYSICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMI A WHITE (CHIEF EXECUTIVE OFFICER)
(734) 632-0175
Entity
Organization
Contact information
Practice address
18101 OAKWOOD BLVD, ISU OBSERVATION UNIT, DEARBORN, MI 48124-4089
(313) 982-5770
(313) 982-5771
Mailing address
38935 ANN ARBOR RD, CREDENTIALING/PAYER CONTRACTING, LIVONIA, MI 48150-3397
(734) 805-0488
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
Primary
—
MI
363A00000X
Physician Assistant
—
MI
363L00000X
Nurse Practitioner
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811002710
—
MI
Enumeration date
08/20/2006
Last updated
12/26/2013
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