PLYMOUTH ASTHMA & ALLERGY CENTER PC
Allergy and Immunology
Plymouth, Michigan
Provider NPI: 1306808407
Organization Information:Organization Name: PLYMOUTH ASTHMA & ALLERGY CENTER PC
Practice Location:
9398 N LILLEY RD PLYMOUTH, MI 48170 US
Tel: 734-459-2255 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
9398 N LILLEY RD PLYMOUTH, MI 48170 US
Tel: 734-459-2255 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207K00000X | Physicians Allergy & Immunology | MI | 5101004511 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 2628611 | MI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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