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General NPI Number Information
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NPI Number | 1760538821
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Entity Type | Organization
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Legal Business Name | MICHIGAN INSTITUTE OF MEDICINE PC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 38525 8 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-1012
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Country | US
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Telephone | 734-542-5512
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Fax | 734-542-3115
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Provider Business Mailing Address
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Address Line | 38525 8 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-1012
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Country | US
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Telephone | 734-542-5512
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Fax | 734-542-3115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH JEFFREY PIERCE
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Credential | MD
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Telephone | 313-563-3332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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