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General NPI Number Information
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NPI Number | 1457527491
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Entity Type | Organization
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Legal Business Name | DETROIT MEDICAL CENTER
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE ST
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-745-4008
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Fax |
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Provider Business Mailing Address
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Address Line | 21965 WORCESTER DR
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City | NOVI
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State | MI
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Zip | 48374-3955
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Country | US
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Telephone | 248-345-4965
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Fax |
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Authorized Official
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Title or Position | CHEIF DIVISION OF ENDOCRINOLOGY
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Name | PROF. ABDUL ABOU-SAMRA
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Credential | MD
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Telephone | 313-745-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4301082508
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License Number State | MI
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