Provider Demographics
NPI:1689439366
Name:PATTERSON PHELBOTOMY LLC
Entity Type:Organization
Organization Name:PATTERSON PHELBOTOMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ARNESS
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD,DO,CMA,CPT,PA
Authorized Official - Phone:586-519-7759
Mailing Address - Street 1:8444 ENGLEMAN
Mailing Address - Street 2:
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1567
Mailing Address - Country:US
Mailing Address - Phone:586-519-7759
Mailing Address - Fax:
Practice Address - Street 1:8444 ENGLEMAN STREET
Practice Address - Street 2:128 BED 2
Practice Address - City:CENTERLINE
Practice Address - State:MI
Practice Address - Zip Code:48015
Practice Address - Country:US
Practice Address - Phone:158-651-9775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty