Acosta, Alfonso

Acosta, Alfonso is an individual health care provider with primary practice located at 7173 Ilanaway Dr , West Bloomfield MI 48324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Acosta, Alfonso can be contacted via phone (586) 929-0842.

Contact Information

Primary practice address
7173 Ilanaway Dr West Bloomfield MI 48324
Phone: (586) 929-0842
Fax: (248) 366-0065
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301064369 Michigan

Profile Details

NPI number 1629072038
LBN Legal business name Acosta, Alfonso
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Sep 13th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629072038 NPPES
Michigan Other 1106335602 BC
Michigan MEDICAID 4442468 BC
Michigan Other P00193884 BC
Michigan Other 143552 BC

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