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Organization
ANK PC
Active
Organization
ANK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE R SHERRY (OFFICE MANAGER)
(313) 565-3365
Entity
Organization
Contact information
Practice address
2012 MONROE ST STE 102, DEARBORN, MI 48124-2938
(313) 565-3365
(313) 565-3440
Mailing address
2012 MONROE ST STE 102, DEARBORN, MI 48124-2938
(313) 565-3365
(313) 565-3440
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4301060472
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829528
BCBS PROVIDER NUMBER
MI
01
—
4301060472
STATE ID
MI
Enumeration date
03/15/2007
Last updated
08/22/2020
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