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 |