| NPI | 1194590307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MILLER Director Of Rcm 248-331-7908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2024-10-18 |