Organization · NPI-2
A3 Medical
Internal Medicine · Bloomfield, MI
NPI number1366798373
StatusActive
Last updated in NPPESOct 14, 2022
Details
- NPI
- 1366798373
- Entity type
- Organization (NPI-2)
- Legal business name
- A3 Medical
- Organization subpart
- No
- Enumeration date
- Jul 27, 2012
- Certification date
- Oct 14, 2022
- Last updated
- Oct 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 4301080609 | MI | Yes |
| 207Q00000X | Family Medicine | 4301083253 | MI | |
| 261QU0200X | Clinic/Center, Urgent Care | – | – |
Practice location
4050 W Maple RoadSuite 101
Bloomfield, MI 48301
Phone 248-885-8211 · Fax 248-855-8357
Mailing address
4050 W Maple RoadSuite 101
Bloomfield, MI 48301
Phone 248-885-8211 · Fax 248-855-8357
Authorized official
Supak Sookkasikon
Not Applicable
2488858211
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