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General NPI Number Information
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NPI Number | 1255427209
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Entity Type | Organization
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Legal Business Name | SWETECH MEDICAL CENTER, P.C.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 43600 GARFIELD RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1120
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Country | US
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Telephone | 586-228-0400
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Fax | 586-228-9112
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Provider Business Mailing Address
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Address Line | 43600 GARFIELD RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1120
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Country | US
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Telephone | 586-228-0400
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Fax | 586-228-9112
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | STACEY MARIE MONTECILLO
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Credential |
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Telephone | 586-228-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101009509
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License Number State | MI
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