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Organization
IMID CONSULTANTS PC
Active
Organization
IMID CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BRENDA LEE LUTHER (SENIOR BILLER)
(248) 229-6255
Entity
Organization
Contact information
Practice address
2300 HAGGERTY, STE 1190, W BLOOMFIELD, MI 48322
(248) 229-6255
(248) 624-9825
Mailing address
PO BOX 33321, DRAWER 110, DETROIT, MI 48232-5321
(248) 229-6255
(248) 624-9825
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301054621
MI
Other
Enumeration date
07/17/2006
Last updated
08/22/2020
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