| NPI | 1104499268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LUNDIN VP Payer Relations 248-921-4652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-11-10 |