| NPI | 1962808162 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine | 
| 207R00000X Internal Medicine | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2080P0214X Pediatrics, Pediatric Pulmonology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2014-11-15 | 
| Last Update Date | 2021-08-12 |