# MED SOURCE SERVICES INC

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

## Provider details

- **NPI number:** 1154643112
- **Authorized official:** MR. CLARENCE O DIXON (PRESIDENT)
- **Authorized official phone:** (248) 746-0882

## Contact information

- **Practice address:** 24901 NORTHWESTERN HWY, SUITE 205, SOUTHFIELD, MI 48075-2203
- **Practice address phone:** (248) 357-2100
- **Practice address fax:** (248) 357-4272
- **Mailing address:** 24901 NORTHWESTERN HWY, SUITE 205, SOUTHFIELD, MI 48075-2203
- **Mailing address phone:** (248) 357-2100
- **Mailing address fax:** (248) 357-2380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 202C00000X | Independent Medical Examiner Physician | — | NULL | Yes |
| 202C00000X | Independent Medical Examiner Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2010
- **Last updated:** 02/18/2010