| NPI | 1578891750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE Managing Member 248-741-6909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 291U00000X Clinical Medical Laboratory (Licence: MI 23D0368331) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2021-01-25 |