| NPI | 1134748643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY BARKER Credentialing Manager 734-373-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-02-18 |