| NPI | 1972873800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L CREGER Billing Specialist 517-783-2696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI GL010466) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI GL010466) |
| 207R00000X Internal Medicine (Licence: MI JA011504) | |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |