| NPI | 1063917425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LOCKARD Sr Revenue Management Analyst 734-343-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| 207R00000X Internal Medicine | |
| 207Q00000X Family Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |