| NPI | 1184409955 |
|---|---|
| Doing Business As | GREAT LAKES MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | SALWA SIRELKHATIM MOHAMEDAHMED Owner 810-653-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-09-22 |