| NPI | 1114045960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P GUSHO CFO Se Mi Region 248-858-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| 208000000X Pediatrics | |
| 363AM0700X Physician Assistant, Medical | |
| 207V00000X Obstetrics & Gynecology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 207R00000X Internal Medicine | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 363L00000X Nurse Practitioner | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2017-10-05 |