Provider Demographics
NPI:1649215914
Name:NOVI INTERNAL MEDICINE AND PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:NOVI INTERNAL MEDICINE AND PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-374-0502
Mailing Address - Street 1:39475 LEWIS DRIVE
Mailing Address - Street 2:STE 130
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2961
Mailing Address - Country:US
Mailing Address - Phone:248-374-0502
Mailing Address - Fax:248-374-0567
Practice Address - Street 1:39475 LEWIS DRIVE
Practice Address - Street 2:STE 130
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2961
Practice Address - Country:US
Practice Address - Phone:248-374-0502
Practice Address - Fax:248-374-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty