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General NPI Number Information
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NPI Number | 1790098069
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Entity Type | Organization
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Legal Business Name | SIERRA MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 2141 E JEFFERSON AVE
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City | DETROIT
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State | MI
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Zip | 48207-4128
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Country | US
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Telephone | 313-567-4720
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Fax | 313-567-1698
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Provider Business Mailing Address
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Address Line | 2141 E JEFFERSON AVE
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City | DETROIT
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State | MI
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Zip | 48207-4128
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Country | US
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Telephone | 313-567-4720
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Fax | 313-567-1698
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL S PIEH
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Credential | MD
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Telephone | 734-717-0848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 4301083312
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License Number State | MI
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