Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jun 25, 2024
License(s)
4351053397 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2075 WHITETREE DR | Monroe, MI 48162-9702 | 720-503-4888 |
| LOCATION | 650 STEWART RD | Monroe, MI 48162-4222 | 734-240-8430 |
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.