Most Relevant Information
Provider Data
| NPI Number: | 1003496696 |
| Provider Name: | HOMA BOMS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2021 |
| Last Updated: | 04/09/2021 |
Provider Practice Location
4201 SAINT ANTOINE ST STE 4E4F
DETROIT
MI
482012153
Practice Location Phone/Fax
| Phone: | 3137454380 |
| Fax: |
Provider Mailing Location
7512 SHELDON PARK DR
NOLENSVILLE
TN
371359571
Provider Mailing Phone/Fax
| Phone: | 6158189976 |
| Fax: |