| NPI | 1053463778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN MARCOTTE VP/CFO 248-338-5691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 630120) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 630120) |
| 207P00000X Emergency Medicine (Licence: MI 630120) | |
| 207R00000X Internal Medicine (Licence: MI 630120) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 630120) | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 208000000X Pediatrics (Licence: MI 630120) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 630120) | |
| 208D00000X General Practice (Licence: MI 630120) | |
| 213E00000X Podiatrist (Licence: MI 630120) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-05-01 |