| NPI | 1730418831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN SHAW Credentialing Supervisor 517-485-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301068267) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2020-01-14 |