Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
Mar 25, 2021
License(s)
4351048401 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 22250 PROVIDENCE DR STE 705 | Southfield, MI 48075-6215 | 248-993-5678 |
| MAILING | 22250 PROVIDENCE DR STE 705 | Southfield, MI 48075-6215 | 248-552-9858 |
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.