| A.w.c. Fairclough Md Pc | |
|
989 University Dr Suite 107 Pontiac MI 48342-1885 | |
| (248) 334-4773 | |
| (248) 334-8230 |
| Full Name | A.w.c. Fairclough Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 989 University Dr, Pontiac, Michigan |
| Authorized Official Name and Position | Anthony Fariclough (PRESIDENT) |
| Authorized Official Contact | 2483344773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A.w.c. Fairclough Md Pc 989 University Dr Suite 107 Pontiac MI 48342-1885 Ph: (248) 334-4773 | A.w.c. Fairclough Md Pc 989 University Dr Suite 107 Pontiac MI 48342-1885 Ph: (248) 334-4773 |
| NPI Number | 1104144526 |
|---|---|
| Provider Enumeration Date | 05/10/2010 |
| Last Update Date | 07/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104144526 | NPI | - | NPPES |
| 0637997 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | AF036119 (Michigan) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | AF036119 (Michigan) | Secondary |
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