Provider Demographics
NPI:1134660376
Name:HOME VISITING DOCTORS PLLC
Entity Type:Organization
Organization Name:HOME VISITING DOCTORS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BABU
Authorized Official - Middle Name:
Authorized Official - Last Name:KONERU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-276-6501
Mailing Address - Street 1:17515 W 9 MILE RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4400
Mailing Address - Country:US
Mailing Address - Phone:734-276-6501
Mailing Address - Fax:
Practice Address - Street 1:17515 W 9 MILE RD STE 180
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4400
Practice Address - Country:US
Practice Address - Phone:734-276-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty