Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 9, 2016
License(s)
C06091 (MD), 5601008031 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3621 S STATE ST | Ann Arbor, MI 48108-1633 | 734-647-5299 |
| LOCATION | 1500 E MEDICAL CENTER DR | Ann Arbor, MI 48109-5000 | 734-936-4000 |
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.