| NPI | 1952715153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOSSAM A HOSSEIN Manager 313-915-4632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 5101006652) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101006652) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301405559) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301405324) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2015-01-13 |