# BETTS MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083908081
- **Authorized official:** MRS. LAQUINTA L EDWARDS (BILLER)
- **Authorized official phone:** (248) 327-6636

## Contact information

- **Practice address:** 21040 GREENFIELD RD, STE 200, OAK PARK, MI 48237-3025
- **Practice address phone:** (248) 967-1888
- **Practice address fax:** (248) 967-1885
- **Mailing address:** PO BOX 21790, DETROIT, MI 48221-0790
- **Mailing address phone:** (248) 967-1888
- **Mailing address fax:** (248) 967-1885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301040115 | MI | Yes |

## Other

- **Enumeration date:** 06/07/2011
- **Last updated:** 02/06/2012