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General NPI Number Information
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NPI Number | 1831433218
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Entity Type | Organization
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Legal Business Name | CONCERTO MEDICAL GROUP OF MICHIGAN, P.C.
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Dates
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Enumeration Date | 11/25/2012
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 7430 2ND AVE STE 210
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City | DETROIT
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State | MI
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Zip | 48202-2739
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Country | US
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Telephone | 313-748-4200
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Fax | 313-748-4186
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Provider Business Mailing Address
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Address Line | 7430 2ND AVE STE 210
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City | DETROIT
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State | MI
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Zip | 48202-2739
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Country | US
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Telephone | 313-748-4200
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Fax | 313-748-4186
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. CINDY RITA BECKER
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Credential | ESQ.
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Telephone | 949-398-8413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4704203621
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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