Organization · Type 2 NPI

Legarius

Primary Care Nurse Practitioner · Southfield, MI

NPI number 1366976375 Active

Practice location

23077 Greenfield Rd, STE156
Southfield, MI 48075-3709

Mailing address

6424 Summer Ct
West Bloomfield, MI 48322-2234

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000X4301055371 (MI)
Primary Care Nurse Practitioner Primary 363LP2300X4704238009 (MI)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1366976375

Legarius's National Provider Identifier is 1366976375, issued on Apr 17, 2017. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Southfield, MI. The record was last updated on Apr 24, 2017.