| NPI | 1730386913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA JOANNE SHAMOUN Office Manager 248-552-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: MI 4301068505) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: MI MT068505) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-10-17 |