Healthcare Provider Details

I. General information

NPI: 1629274030
Provider Name (Legal Business Name): MIDWEST HEALTH CENTER-BROOKSIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8790 TELEGRAPH RD
TAYLOR MI
48180-2491
US

IV. Provider business mailing address

8790 TELEGRAPH RD
TAYLOR MI
48180-2491
US

V. Phone/Fax

Practice location:
  • Phone: 313-292-3900
  • Fax: 313-292-0038
Mailing address:
  • Phone: 313-292-3900
  • Fax: 313-292-0038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: MARK B SAFFER
Title or Position: CEO
Credential: DPM
Phone: 313-586-6038