| Great Lakes Family Medical Center Pllc | |
|
4420 E Davison St Detroit MI 48212-1744 | |
| (313) 369-1500 | |
| (313) 369-1205 |
| Full Name | Great Lakes Family Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4420 E Davison St, Detroit, Michigan |
| Authorized Official Name and Position | Arunima Shirvastava (OWNER) |
| Authorized Official Contact | 7342662780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Family Medical Center Pllc 28801 Plymouth Rd Livonia MI 48150-2385 Ph: (734) 266-2780 | Great Lakes Family Medical Center Pllc 4420 E Davison St Detroit MI 48212-1744 Ph: (313) 369-1500 |
| NPI Number | 1598737769 |
|---|---|
| Provider Enumeration Date | 02/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598737769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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