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PROVIDER SERVICE ORGANIZATION
NPI 1447610704
Family Medicine - Geriatric Medicine in Canton, MI

Active since February 29, 2016
7233 PROVINCIAL CT, CANTON, MI 48187(734) 516-4239(734) 404-5292 Get Directions Write a Review

NPPES record last updated: June 6, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Provider Service Organization NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDER SERVICE ORGANIZATION (NPI 1447610704) is a healthcare organization registered as a geriatric medicine in Canton, Michigan and active in the NPI registry since February 2016. The organization lists Ramon Villanueva, President, as its authorized official.

NPPES Registry Identity

NPI1447610704
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NamePROVIDER SERVICE ORGANIZATION
Location Address7233 PROVINCIAL CTCanton, MI 48187-2121
Mailing Address7233 Provincial CtCanton, MI 48187-2121 · (734) 516-4239 · Fax (734) 404-5292
Phone(734) 516-4239
Fax(734) 404-5292
Organization SubpartNo
Authorized OfficialRamon VillanuevaPresident · (734) 516-4239
Enumeration DateFebruary 29, 2016
Last NPPES UpdateJune 6, 2016
✔ NPI 1447610704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
7233 PROVINCIAL CT, Canton, MI 48187
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provider Service Organization's NPI number?

The NPI number for Provider Service Organization is 1447610704. It was assigned to this organization in the NPPES registry on February 29, 2016.

Where is Provider Service Organization located?

Provider Service Organization is located at 7233 Provincial Ct, Canton, MI 48187. The listed phone number is (734) 516-4239.

What is Provider Service Organization's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

When was this NPI record last updated?

The NPPES record for Provider Service Organization was last updated on June 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.