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General NPI Number Information
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NPI Number | 1902928070
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Entity Type | Organization
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Legal Business Name | CATHERINE MCAULEY HEALTH SERVICES
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 524 BYRON RD
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City | HOWELL
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State | MI
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Zip | 48843-1410
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Country | US
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Telephone | 517-545-6618
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Fax |
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Provider Business Mailing Address
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Address Line | 2691 RELIABLE PARKWAY
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City | CHICAGO
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State | IL
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Zip | 60686-0026
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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 CEO
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Name | GARRY C FAJA
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Credential |
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Telephone | 734-975-4101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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