Provider Demographics
NPI:1265859920
Name:AVALON CONSULTANTS PLLC
Entity Type:Organization
Organization Name:AVALON CONSULTANTS PLLC
Other - Org Name:AVALON PHYSICIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SARAFA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-884-4279
Mailing Address - Street 1:21800 HAGGERTY RD STE 113
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9051
Mailing Address - Country:US
Mailing Address - Phone:888-882-3783
Mailing Address - Fax:888-667-3531
Practice Address - Street 1:21800 HAGGERTY RD STE 113
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-9051
Practice Address - Country:US
Practice Address - Phone:888-882-3783
Practice Address - Fax:888-667-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty