Provider Demographics
NPI:1447425236
Name:A HOME PRIMARY CARE DOCTORS PLLC
Entity type:Organization
Organization Name:A HOME PRIMARY CARE DOCTORS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY, TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARSENIA
Authorized Official - Middle Name:KOH
Authorized Official - Last Name:GUEVARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-608-1408
Mailing Address - Street 1:115 SCARBOROUGH
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43171 DALCOMA DR STE 8
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6307
Practice Address - Country:US
Practice Address - Phone:248-608-1408
Practice Address - Fax:248-608-1408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A HOME PRIMARY CARE DOCTORSPLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-23
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty