| NPI | 1104225168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2018-08-02 |