Individual
XAVIER OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4074 HOWE RD, WAYNE, MI 48184-1830
(734) 394-9802
Mailing address
4074 HOWE ROAD, WAYNE, MI 48184
(734) 394-9802
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02273942
—
MI
Enumeration date
12/23/2015
Last updated
12/23/2015
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