Registry details
Type
Individual
Primary specialty
Internal Medicine, Hematology & Oncology
Enumerated
Jun 4, 2006
License(s)
5101007693 (MI), C2-0024798 (DE), C2-0024798 (DE), C2-0024798 (DE), 5101007693 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 27207 LAHSER RD STE200 B | Southfield, MI 48034-2168 | 248-358-4892 |
| MAILING | PO BOX 321061 | Detroit, MI 48232-1061 | 248-543-8070 |
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