Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Mar 21, 2013
License(s)
35.128365 (OH), 4301103013 (MI), 35.128365 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2799 W GRAND BLVD HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT | Detroit, MI 48202-2608 | 313-916-2600 |
| MAILING | 1 FORD PL STE 2E | Detroit, MI 48202-3450 | 313-874-4316 |
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.