| NPI | 1306251699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHRISTOPHER MILLER President 734-936-3568 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2080P0216X Pediatrics, Pediatric Rheumatology | |
| 2080S0010X Pediatrics, Sports Medicine | |
| 2080S0010X Pediatrics, Sports Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 2083S0010X Preventive Medicine, Sports Medicine | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-04-30 |