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General NPI Number Information
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NPI Number | 1235115460
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Entity Type | Organization
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Legal Business Name | COUNTY OF GENESEE OFFICE OF CONTROLLER
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 420 W 5TH AVE
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City | FLINT
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State | MI
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Zip | 48503
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Country | US
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Telephone | 810-257-3736
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Fax | 810-257-3785
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Provider Business Mailing Address
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Address Line | 420 W 5TH AVE
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City | FLINT
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State | MI
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Zip | 48503
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Country | US
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Telephone | 810-257-3736
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Fax | 810-257-3785
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DANIS RUSSELL
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Credential |
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Telephone | 810-257-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | ME0100974
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License Number State | MI
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