| NPI | 1649560467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE C JACKS PORTER CFO 989-894-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2018-08-07 |