Provider Demographics
NPI:1386679892
Name:DOCTORS HOME CARE
Entity Type:Organization
Organization Name:DOCTORS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWERENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-443-8100
Mailing Address - Street 1:24361 GREENFIELD RD
Mailing Address - Street 2:115
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3139
Mailing Address - Country:US
Mailing Address - Phone:248-443-8100
Mailing Address - Fax:248-443-8120
Practice Address - Street 1:24361 GREENFIELD RD
Practice Address - Street 2:115
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3139
Practice Address - Country:US
Practice Address - Phone:248-443-8100
Practice Address - Fax:248-443-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006349302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization