| NPI | 1760679468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER LOGAN Billing Manager 734-844-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI HD081239) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |