| NPI | 1871847640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE M WEEKS Billing/Credentialing Manager 248-203-1282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |