| NPI | 1609970359 |
|---|---|
| Doing Business As | CLARKSTON PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | CLARENCE SEVILLIAN CEO/President 248-338-5380 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2011-04-08 |