Registry details
Type
Individual
Primary specialty
Internal Medicine, Hematology & Oncology
Enumerated
May 17, 2011
License(s)
4301098397 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1560 E MAPLE RD STE 400 - CREDENTIALING DEPARTMENT | Troy, MI 48083-1135 | 800-527-6266 |
| LOCATION | 4100 JOHN R ST | Detroit, MI 48201-2013 | 800-527-6266 |
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