Provider Demographics
NPI:1467506832
Name:PHYSICIANS FOR HEALTH, P.L.C.
Entity Type:Organization
Organization Name:PHYSICIANS FOR HEALTH, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-483-5300
Mailing Address - Street 1:15590 W 13 MILE RD
Mailing Address - Street 2:STE B
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5642
Mailing Address - Country:US
Mailing Address - Phone:248-483-5300
Mailing Address - Fax:248-483-5301
Practice Address - Street 1:15590 W 13 MILE RD
Practice Address - Street 2:STE B
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-5642
Practice Address - Country:US
Practice Address - Phone:248-483-5300
Practice Address - Fax:248-483-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N60770Medicare PIN