| NPI | 1942829155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY STEVENS Owner 248-824-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 208D00000X General Practice | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2022-10-21 |