| NPI | 1023342474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH ILEEN CHARLES Practice Manager 517-887-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301049233) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301063626) |
| 208000000X Pediatrics (Licence: MI 4301078945) | |
| 208000000X Pediatrics (Licence: MI 4301086445) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-01 |