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General NPI Number Information
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NPI Number | 1205820461
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Entity Type | Organization
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Legal Business Name | MICHIGAN BONE AND MINERAL CLINIC, P.C.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 22201 MOROSS RD SUITE 260
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-640-7700
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Fax | 313-640-1740
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Provider Business Mailing Address
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Address Line | 22201 MOROSS RD SUITE 260
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-640-7700
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Fax | 313-640-1740
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Authorized Official
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Title or Position | OWNER
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Name | HENRY G. BONE
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Credential | MD
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Telephone | 313-640-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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