Registry details
Type
Individual
Primary specialty
Dermatology, Dermatopathology
Enumerated
Jun 8, 2009
License(s)
74802 (GA), 4301100629 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1314 N MACOMB ST | Monroe, MI 48162-3131 | 734-242-6872 |
| MAILING | 1314 N MACOMB ST | Monroe, MI 48162-3131 | 734-242-6872 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.