Organization · NPI-2

Anne-Mare Ice MD PC

Pediatrics, Adolescent Medicine · Detroit, MI

NPI number1639347586
StatusActive
Last updated in NPPESFeb 13, 2008

Details

NPI
1639347586
Entity type
Organization (NPI-2)
Legal business name
Anne-Mare Ice MD PC
Organization subpart
No
Enumeration date
Feb 13, 2008
Last updated
Feb 13, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080A0000X Pediatrics, Adolescent Medicine4301031683MIYes

Practice location

22341 W 8 Mile Rd
Detroit, MI 48219-1217

Phone 313-255-2209

Mailing address

22341 W 8 Mile Rd
Detroit, MI 48219-1217

Authorized official

Kassandra A Hill
General Manager
3132554672

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