| NPI | 1447277496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA LYNN STILES Office Manager/Biller 810-982-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301051703) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-11-04 |