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1710945746
CHARLES THEODOROVICH
BINGHAM FARMS, MI
NPI
1710945746
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: MI 4704101769)
Enumeration Date
2006-05-01
Last Update Date
2014-04-01
Business Address
-- CHARLES THEODOROVICH CRNA
30200 TELEGRAPH RD SUITE 220
BINGHAM FARMS, MI 48025-4502
Phone number: 248-258-5058
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Mailing Address
-- CHARLES THEODOROVICH CRNA
321 N GORDON ST
MARSHALL, MI 49068-1214
Phone number:
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