Birmingham Medical PLLC
Family Medicine in Birmingham, MI. Organization (NPI-2).
NPI number1982806782
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1982806782
- Entity type
- Organization (NPI-2)
- Legal business name
- Birmingham Medical PLLC
- Organization subpart
- No
- Enumeration date
- Jun 4, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
180 E Brown StBirmingham, MI 48009-6237
Phone 248-645-1000
Mailing address
180 E Brown StBirmingham, MI 48009-6237
Phone 248-645-1000
Authorized official
Lyle Scott Grant
Owner
2486451000
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