Michigan Medical Mall
Family Medicine Physician in Detroit, MI(View on Map)
Legal Business Name
Michigan Medical Mall
NPI Number
1194133686
NPI Type
Organization
Enumeration Date
07/28/2014
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
17350 LIVERNOIS AVE
17350 LIVERNOIS AVE
City
Detroit
Detroit
State
MI
MI
Postal Code
48221-2759
48221-2759
Country
US
US
Telephone Number
N/A
(256) 262-9310
Authorized Official
Name
Schara Davis
Title or Position
OWNER/INCORPORATOR
Telephone Number
(256) 262-9310
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/28/2014
Provider Address
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