| NPI | 1356572135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS IDDINGS D.O. 810-762-8092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MI 5101014246) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2017-01-04 |