| NPI | 1639318520 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JEFFREY STEVENS Owner 248-824-6000 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| 363LF0000X Nurse Practitioner, Family | |
| 208D00000X General Practice | |
| Enumeration Date | 2009-02-17 | 
| Last Update Date | 2025-09-30 |