Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
Jun 6, 2006
License(s)
4301062290 (MI), 4301062290 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4201 SAINT ANTOINE ST STE 5A | Detroit, MI 48201-2153 | 313-966-2492 |
| MAILING | 400 MACK AVE | Detroit, MI 48201-2136 |
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