| Dtna - Detroit | |
|
13440 W Outer Dr Detroit MI 48239-1309 | |
| (313) 324-8180 | |
| (312) 324-8186 |
| Full Name | Dtna - Detroit |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13440 W Outer Dr, Detroit, Michigan |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dtna - Detroit 5500 Maryland Way Brentwood TN 37027-7048 Ph: (313) 324-8180 | Dtna - Detroit 13440 W Outer Dr Detroit MI 48239-1309 Ph: (313) 324-8180 |
| NPI Number | 1790356764 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 02/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790356764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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