Athletic Scholars

Specialty details in registry · Detroit, MI

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At a glance

16909 Prairie St, Detroit, MI 48221-2916

NPPES record updated Aug 8, 2025. Public records can lag behind changes at a practice.

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Practice location

16909 Prairie St
Detroit, MI 48221-2916

Professional details: NPI, taxonomy & registry record

NPI1194600114

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251S00000X
Enumeration date: Aug 8, 2025
Record updated: Aug 8, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251S00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

16909 Prairie St
Detroit, MI 48221-2916

Phone: (313) 699-1207

Mailing address

16909 PRAIRIE ST

DETROIT, MI 482212916

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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