Superior Family Medicine Clinic PC
Family Medicine in Southfield, MI. Organization (NPI-2).
NPI number1861728362
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1861728362
- Entity type
- Organization (NPI-2)
- Legal business name
- Superior Family Medicine Clinic PC
- Organization subpart
- No
- Enumeration date
- Oct 19, 2009
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
23077 Greenfield Rd Ste 489Southfield, MI 48075-3740
Phone 248-395-6312 · Fax 248-395-6314
Mailing address
Po Box 47068Oak Park, MI 48237-4768
Phone 313-247-7270
Authorized official
Jira G Coumarbatch
Owner
3132477270
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