Provider Demographics
NPI:1669634358
Name:VISITING PHYSICIAN P.C.
Entity Type:Organization
Organization Name:VISITING PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIOGUY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-289-6651
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:240
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2581
Mailing Address - Country:US
Mailing Address - Phone:248-968-2500
Mailing Address - Fax:248-968-2501
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:240
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-968-2500
Practice Address - Fax:248-968-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076297364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1427197417OtherNPI FOR SUNANDA NIOGUY