Renovis Choice Company

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RENOVIS CHOICE COMPANY

Practice address

25433 Saint James
Southfield, MI 48075-1287

Phone

(248) 470-7318

NPI assigned

Jun 22, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Olisaeloka Dallah

Title

Cao

Phone

(248) 470-7318

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1730865197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19785 W 12 MILE RD STE 568",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25433 SAINT JAMES",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751287",
            "telephone_number": "248-470-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVIS CHOICE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "DALLAH",
        "authorized_official_first_name": "OLISAELOKA",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "248-470-7318",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Restorative Counseling Therapeutic Services
• Restore Healing Hands LLC

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.