Provider Demographics
NPI:1629001375
Name:TRINITY HOMECARE PHYSICIANS, P.L.L.C.
Entity Type:Organization
Organization Name:TRINITY HOMECARE PHYSICIANS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-538-8136
Mailing Address - Street 1:18241 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4176
Mailing Address - Country:US
Mailing Address - Phone:313-538-8136
Mailing Address - Fax:313-538-8340
Practice Address - Street 1:18241 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4176
Practice Address - Country:US
Practice Address - Phone:313-538-8136
Practice Address - Fax:313-538-8340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty