| NPI | 1306368923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Provider Affairs 313-874-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 207N00000X Dermatology |
| 207RA0201X Internal Medicine, Allergy & Immunology | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RN0300X Internal Medicine, Nephrology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207RS0012X Internal Medicine, Sleep Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2085R0001X | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2024-08-23 |