Registry details
Type
Individual
Primary specialty
Surgery, Surgery of the Hand
Enumerated
May 24, 2012
License(s)
4301100587 (MI), 4301100587 (MI), 4301100587 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 26211 CENTRAL PARK BLVD STE 201 | Southfield, MI 48076-4158 | 833-667-3627 |
| LOCATION | 17877 W 14 MILE RD | Beverly Hills, MI 48025-3127 | 248-644-3920 |
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.