| NPI | 1124011127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN METZKE Billing Manager 989-356-3485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI MC034224) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI HS024997) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI JM059074) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-08-22 |