| NPI | 1730208778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY FAJA President CEO 734-712-3791 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207ZB0001X Pathology Blood Banking & Transfusion Medicine | |
| 207ZD0900X Pathology Dermatopathology | |
| 207ZI0100X Pathology Immunopathology | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| 363L00000X Nurse Practitioner | |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2010-12-14 |