| NPI | 1386021582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE TATKO CEO 231-745-5057 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2024-06-04 |