Basic Information
| Provider Information | |||||||||
| NPI: | 1548639909 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEENEY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1655 EAGLE TRL | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483716064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109695108 | ||||||||
| FaxNumber: | 2482871148 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 S TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483020046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484568150 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2015 | ||||||||
| LastUpdateDate: | 09/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 4704237569 | MI | Y | Nursing Service Providers | Registered Nurse |
No ID Information.