Provider Demographics
NPI:1023717493
Name:REFUAH HEALTHCARE SERVICES PLLC
Entity type:Organization
Organization Name:REFUAH HEALTHCARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-440-6069
Mailing Address - Street 1:24777 GREENFIELD RD # 201
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3065
Mailing Address - Country:US
Mailing Address - Phone:248-440-6069
Mailing Address - Fax:248-499-1942
Practice Address - Street 1:24777 GREENFIELD RD # 201
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3065
Practice Address - Country:US
Practice Address - Phone:248-440-6069
Practice Address - Fax:248-499-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty