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PROFESSIONAL PLAZA CLINIC CORPORATION NPI 1992709331


NPI Information

NPI: 1992709331
Provider Name: PROFESSIONAL PLAZA CLINIC CORPORATION
Classification: Legal Medicine - 173000000X
Entity Type: Organization

CLIA Number: 23D0369550

Address:
2395 W GRAND BLVD
DETROIT, MI
ZIP 48208
Phone: (313) 831-2442
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PROFESSIONAL PLAZA CLINIC CORPORATION is a legal medicine in Detroit, MI. The provider is the specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. PROFESSIONAL PLAZA CLINIC CORPORATION NPI is 1992709331. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2395 W GRAND BLVD
DETROIT, MI
ZIP 48208-210
Phone: (313) 831-2442
Fax: (313) 831-2444

The provider's authorized official is Andrea P Mcbride .
The authorized official title is Ceo/president and has the following contact phone number (313) 218-2709.

The CLIA number assigned to this NPI record is 23D0369550 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2005 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1173000000XLegal MedicineMICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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