Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
May 10, 2007
License(s)
4301083243 (MI), 4301083243 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4160 JOHN R ST STE 804 | Detroit, MI 48201-2014 | 313-745-4525 |
| MAILING | 400 MACK AVE | Detroit, MI 48201-2136 |
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