| NPI | 1124075809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ZDRODOWSKI Administrator 231-876-6730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RH0003X Internal Medicine Hematology & Oncology | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-02-20 |