| NPI | 1659560696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN S MELVILLE Office Manager 313-582-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 115993) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |