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Organization
DIVINE MEDICAL CENTER P C
Active
Organization
DIVINE MEDICAL CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CERMEN CARDONA M.D (PRESIDENT)
(313) 393-3141
Entity
Organization
Contact information
Practice address
901 W GRAND BLVD, DETROIT, MI 48208-2353
(313) 393-3141
(313) 393-3144
Mailing address
PO BOX 806464, SAINT CLAIR SHORES, MI 48080-6464
(313) 393-3141
(313) 393-3144
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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