Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Feb 13, 2007
License(s)
4301083214 (MI), 4301083214 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | G1071 N BALLENGER HWY PARK PLAZA SUITE 311 | Flint, MI 48504-4453 | 810-221-7057 |
| LOCATION | G1071 N BALLENGER HWY PARK PLAZA SUITE 311 | Flint, MI 48504-4453 | 810-221-7057 |
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.