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General NPI Number Information
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NPI Number | 1609235217
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Entity Type | Organization
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Legal Business Name | MACOMB EMERGENCY PHYSICIANS PLLC
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 1000 HARRINGTON ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2920
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Country | US
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Telephone | 586-493-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776421
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City | CHICAGO
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State | IL
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Zip | 60677-6421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES LARKIN
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Credential | DO
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Telephone | 586-493-3084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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