Healthcare Provider Details

I. General information

NPI: 1457319790
Provider Name (Legal Business Name): STRAITH CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32000 TELEGRAPH RD
BINGHAM FARMS MI
48025-2442
US

IV. Provider business mailing address

32000 TELEGRAPH RD
BINGHAM FARMS MI
48025-2442
US

V. Phone/Fax

Practice location:
  • Phone: 248-647-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PERLA FORBES
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 248-647-5800