| Northwest Industrial And Medical Services Pc | |
|
9600 Dexter Ave Detroit MI 48206-1816 | |
| (313) 894-7881 | |
| Not Available |
| Full Name | Northwest Industrial And Medical Services Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 9600 Dexter Ave, Detroit, Michigan |
| Authorized Official Name and Position | Carl Dennis Fowler (OWNER PRESIDENT) |
| Authorized Official Contact | 3138947881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Industrial And Medical Services Pc 9600 Dexter Ave Detroit MI 48206-1816 Ph: (313) 894-7881 | Northwest Industrial And Medical Services Pc 9600 Dexter Ave Detroit MI 48206-1816 Ph: (313) 894-7881 |
| NPI Number | 1346364619 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346364619 | NPI | - | NPPES |
| 4517540 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | CF045243 (Michigan) | Primary |
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