Provider Demographics
NPI:1316582372
Name:HOME VISITING DOCTORS ASSOCIATION P.C.
Entity Type:Organization
Organization Name:HOME VISITING DOCTORS ASSOCIATION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALDWAKE
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:313-595-0737
Mailing Address - Street 1:251 N ROSE ST STE 218
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3860
Mailing Address - Country:US
Mailing Address - Phone:313-595-0737
Mailing Address - Fax:269-849-8703
Practice Address - Street 1:251 N ROSE ST STE 218
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3860
Practice Address - Country:US
Practice Address - Phone:313-595-0737
Practice Address - Fax:269-849-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty