Provider Demographics
NPI:1447213418
Name:ASTHMA AND ALLERGIC DISEASE CENTER OF LIVONIA PC
Entity Type:Organization
Organization Name:ASTHMA AND ALLERGIC DISEASE CENTER OF LIVONIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:H
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-478-5221
Mailing Address - Street 1:20228 FARMINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152
Mailing Address - Country:US
Mailing Address - Phone:248-478-5221
Mailing Address - Fax:248-478-8425
Practice Address - Street 1:20228 FARMINGTON ROAD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152
Practice Address - Country:US
Practice Address - Phone:248-478-5221
Practice Address - Fax:248-478-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty