Search › Michigan › 363LA2100X
John Inthavongsa, DNP RN AGACNP-BC
NPI 1588220222 · on the registry since 2019 · sole proprietor
Practice
- Address
- 4201 Saint Antoine St
Detroit, MI 48201 - Phone
- (313) 745-3000
- Fax
- (313) 745-4707
- Organisation at this address
- Walgreen Co
Family Service
Vhs Of Michigan
Ahmed Sawah Md Pc
Rehab Alliance PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 803
Additional practice sites
- 454 W Alexandrine St Apt 18, Detroit, MI
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Also registered as
- 163W00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan