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General NPI Number Information
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NPI Number | 1770853251
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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 | 12/30/2011
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Last Update Date | 05/13/2012
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Provider Practice Location Address
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Address Line | 6071 W OUTER DR EMERGENCY MEDICINE DEPARTMENT
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City | DETROIT
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State | MI
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Zip | 48235-2624
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Country | US
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Telephone | 313-966-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 WASHINGTON BLVD APT 2714
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City | DETROIT
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State | MI
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Zip | 48226-1732
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Country | US
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Telephone | 913-706-1307
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Fax |
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Authorized Official
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Title or Position | PROGRAM COORDINATOR
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Name | GRETCHEN BROWNLOW
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Credential |
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Telephone | 313-966-1020
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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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