Powell, Ava Ann
Powell, Ava Ann is an individual health care provider with primary practice located at 36175 Harper Ave , Clinton Twp MI 48035-3274. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Powell, Ava Ann can be contacted via phone (586) 464-0731.Contact Information
Primary practice address
36175 Harper Ave
Clinton Twp MI 48035-3274
Phone: (586) 464-0731
Fax: (586) 464-1954
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 070529 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 5101017313 | Michigan |
Profile Details
| NPI number | 1083854343 |
|---|---|
| LBN Legal business name | Powell, Ava Ann |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2009 |
| Last updated | Mar 4th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083854343 | NPPES |
| Georgia | Other | 52609286002 | BCBSGA |
| Georgia | Other | P01224298 | BCBSGA |
| Georgia | Other | 52609286001 | BCBSGA |
| Georgia | MEDICAID | 003137958A | BCBSGA |
| Georgia | MEDICAID | 003137966A | BCBSGA |
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