| Beaumont Health | |
|
15777 Northline Southgate MI 48195 | |
| (313) 570-7906 | |
| Not Available |
| Full Name | Beaumont Health |
|---|---|
| Speciality | Clinic/center |
| Location | 15777 Northline, Southgate, Michigan |
| Authorized Official Name and Position | Diane Pearl (NURSE PRACTITIONER) |
| Authorized Official Contact | 3135707906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beaumont Health 17801 Snow Dearborn MI 48124 Ph: () - | Beaumont Health 15777 Northline Southgate MI 48195 Ph: (313) 570-7906 |
| NPI Number | 1497290456 |
|---|---|
| Provider Enumeration Date | 12/30/2016 |
| Last Update Date | 12/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497290456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4704208352 (Michigan) | Primary |
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