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General NPI Number Information
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NPI Number | 1275401440
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Entity Type | Organization
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Legal Business Name | M MEDICAL MI PLLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 5201 CONNER ST
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City | DETROIT
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State | MI
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Zip | 48213-3405
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Country | US
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Telephone | 313-571-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 6 E EAGER ST
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City | BALTIMORE
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State | MD
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Zip | 21202-2506
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Country | US
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Telephone | 410-870-9380
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Fax | 410-431-3550
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KRYSTLE D BROWN
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Credential |
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Telephone | 410-800-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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