Provider Demographics
NPI:1467727420
Name:DOWNRIVER ENDOCRINOLOGY PLC
Entity Type:Organization
Organization Name:DOWNRIVER ENDOCRINOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-282-3138
Mailing Address - Street 1:15125 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2409
Mailing Address - Country:US
Mailing Address - Phone:734-282-3138
Mailing Address - Fax:734-282-1969
Practice Address - Street 1:15125 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2409
Practice Address - Country:US
Practice Address - Phone:734-407-2311
Practice Address - Fax:734-677-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046311207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty