| NPI | 1043509557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA LEE BENEDETTO CEO 517-748-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1223G0001X Dentist, General Practice | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 183500000X Pharmacist | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 364SW0102X Clinical Nurse Specialist, Women's Health | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-11-17 |