Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Sep 14, 2005
License(s)
4301043707 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2799 W GRAND BLVD FL 3 | Detroit, MI 48202-2608 | 313-916-8078 |
| LOCATION | 2799 W GRAND BLVD FL 3 | Detroit, MI 48202-2608 | 313-916-8078 |
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.