| NPI | 1508992041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL E STACHECKI Owner Managing Agent 248-620-1720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301058225) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301058225) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2014-02-25 |