| NPI | 1174537500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CEBALT Director Of Provider Affairs 313-874-6764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 207V00000X Obstetrics & Gynecology | |
| 208M00000X Hospitalist | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 207W00000X Ophthalmology | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2026-04-28 |