| NPI | 1003125774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE Managing Member 248-348-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2021-02-23 |