| NPI | 1316018971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABATHA LEANNE STAGE Billing Manager 248-853-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2009-07-21 |