| NPI | 1164750949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE EDELEN-STEVENS Office Manager 810-742-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI TS039213) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-29 |