| Surburban Llc | |
|
20905 Greenfield Rd Suite 203 Southfield MI 48075-5360 | |
| (313) 837-0560 | |
| Not Available |
| Full Name | Surburban Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 20905 Greenfield Rd, Southfield, Michigan |
| Authorized Official Name and Position | Charrisa Nadine Williams (OWNER) |
| Authorized Official Contact | 3138370560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Surburban Llc Po Box 760128 Lathrup Village MI 48076-0128 Ph: () - | Surburban Llc 20905 Greenfield Rd Suite 203 Southfield MI 48075-5360 Ph: (313) 837-0560 |
| NPI Number | 1902036304 |
|---|---|
| Provider Enumeration Date | 07/20/2009 |
| Last Update Date | 11/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902036304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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