| NPI | 1124179924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY METHENY Office Manager 248-858-3878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2021-09-15 |