| NPI | 1629384144 |
|---|---|
| Other Name | EDGEWOOD CLINIC |
| Entity Type | Organization |
| Authorized Contact | MOHD S JAFRI Doctor 586-445-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301031532) |
| Enumeration Date | 2010-08-21 |
| Last Update Date | 2011-01-05 |