Provider Demographics
NPI:1053457143
Name:CITI PHYSICIANS INC
Entity Type:Organization
Organization Name:CITI PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-352-9351
Mailing Address - Street 1:26555 EVERGREEN RD STE 1502
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4258
Mailing Address - Country:US
Mailing Address - Phone:248-352-9351
Mailing Address - Fax:248-352-9359
Practice Address - Street 1:26555 EVERGREEN RD STE 1502
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4258
Practice Address - Country:US
Practice Address - Phone:248-352-9351
Practice Address - Fax:248-352-9359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P28390Medicare ID - Type Unspecified