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Organization
GREAT LAKES PHYSICIANS OF REDFORD,P.L.L.C.
Active
Organization
GREAT LAKES PHYSICIANS OF REDFORD,P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSTAK Y VAID M.D. (SOLO OWNER)
(248) 996-8777
Entity
Organization
Contact information
Practice address
25321 5 MILE RD, SUITE # 1, REDFORD, MI 48239-3700
(313) 538-1800
(313) 538-9082
Mailing address
23300 PROVIDENCE DR, SUITE # 104, SOUTHFIELD, MI 48075-3652
(248) 996-8777
(248) 996-8778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1630863
MI
Other
Enumeration date
03/09/2008
Last updated
03/09/2008
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