Abyssinin Loveknot LLC

Organization Active NPI Pain Medicine Physician · Oak Park, MI

NPI 1881908283 · NPPES record last updated Jul 28, 2010

Key facts

NPI
1881908283
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine Physician 208VP0000X
Legal business name
ABYSSININ LOVEKNOT LLC
Practice address
21700 Greenfield Rd
215B
Oak Park, MI 48237-2581
Phone
(248) 968-6899
NPI assigned
Jul 28, 2010
Organization subpart
No

Authorized official

Name
Mr. Malik Fuqua
Title
Owner
Phone
(248) 968-6899

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208VP0000X Yes

Addresses

Primary practice location

21700 Greenfield Rd
215B
Oak Park, MI 48237-2581

Mailing address

21700 Greenfield Rd
215B
Oak Park, MI 48237-2581

Other providers in Oak Park, MI

All providers in Oak Park, MI · Pain Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.