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General NPI Number Information
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NPI Number | 1013313766
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Entity Type | Organization
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Legal Business Name | EPIC MEDICAL LAB PLLC
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 911 E 9 MILE RD
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City | FERNDALE
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State | MI
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Zip | 48220-1934
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Country | US
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Telephone | 248-336-4000
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Fax | 248-291-8753
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Provider Business Mailing Address
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Address Line | 390 ENTERPRISE CT STE 100
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-0320
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Country | US
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Telephone | 248-336-4000
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Fax | 248-291-8753
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GREG NAMAN
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Credential | M.D.
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Telephone | 248-336-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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