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Organization
ADVANCED PHYSICIAN GROUP PLLC
Active
Organization
ADVANCED PHYSICIAN GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE MAYCOCK (BILLING DIRECTOR)
(734) 673-5917
Entity
Organization
Contact information
Practice address
13530 MICHIGAN AVE, SUITE 400, DEARBORN, MI 48126-3574
(313) 945-9800
(314) 667-6915
Mailing address
13530 MICHIGAN AVE, SUITE 400, DEARBORN, MI 48126-3574
(313) 945-9800
(314) 667-6915
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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