| NPI | 1912354986 |
|---|---|
| Doing Business As | MICHIGAN IPA |
| Entity Type | Organization |
| Authorized Contact | ROBERT MAURICE BOUVIER CEO 810-610-7972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LG0600X Nurse Practitioner Gerontology | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-06-23 |