Provider Demographics
NPI:1407747215
Name:HOME MD PLLC
Entity type:Organization
Organization Name:HOME MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-620-0398
Mailing Address - Street 1:4568 W WALTON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-4900
Mailing Address - Country:US
Mailing Address - Phone:855-466-3631
Mailing Address - Fax:833-973-4493
Practice Address - Street 1:4568 W WALTON BLVD STE D
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-4900
Practice Address - Country:US
Practice Address - Phone:855-466-3631
Practice Address - Fax:833-973-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty