Provider Demographics
NPI:1831342914
Name:HOME VISITING DOCTORS, PLLC
Entity type:Organization
Organization Name:HOME VISITING DOCTORS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERCADO-FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-327-4523
Mailing Address - Street 1:23100 PROVIDENCE DR
Mailing Address - Street 2:STE # 152
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3646
Mailing Address - Country:US
Mailing Address - Phone:248-327-4523
Mailing Address - Fax:248-443-7109
Practice Address - Street 1:23100 PROVIDENCE DR
Practice Address - Street 2:STE # 152
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3646
Practice Address - Country:US
Practice Address - Phone:248-327-4523
Practice Address - Fax:248-443-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078684172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty