Provider Demographics
NPI:1205973781
Name:METROPOLITAN MEDICAL ASSOCIATES PC
Entity type:Organization
Organization Name:METROPOLITAN MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-573-9365
Mailing Address - Street 1:28111 HOOVER RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4153
Mailing Address - Country:US
Mailing Address - Phone:586-573-9365
Mailing Address - Fax:586-573-9389
Practice Address - Street 1:28111 HOOVER RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4153
Practice Address - Country:US
Practice Address - Phone:586-573-9365
Practice Address - Fax:586-573-9389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty