| NPI | 1851470744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M RUCKER Enrollment & Patient Accts Manager 517-355-8462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| 208D00000X General Practice | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-04-05 |