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General NPI Number Information
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NPI Number | 1497880249
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Entity Type | Organization
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Legal Business Name | PARKWAY FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 17200 SILVER PKWY
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City | FENTON
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State | MI
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Zip | 48430-3423
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Country | US
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Telephone | 810-714-9660
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Fax | 810-714-9661
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Provider Business Mailing Address
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Address Line | 3495 S CENTER RD
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City | BURTON
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State | MI
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Zip | 48519-1455
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Country | US
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Telephone | 810-424-2007
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Fax | 810-743-1099
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Authorized Official
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Title or Position | CFO
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Name | PAUL GARSON
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Credential |
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Telephone | 810-424-2007
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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 |
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License Number State | MI
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