| NPI | 1356040331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE THOMPSON Billing Manager 586-751-6034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology |
| 207RG0100X Internal Medicine, Gastroenterology | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2026-06-22 |