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Organization
MCLAREN MACOMB
Active
Organization
MCLAREN MACOMB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS M BRISSE (CEO)
(586) 493-8083
Entity
Organization
Contact information
Practice address
36500 S GRATIOT AVE, STE. 102, CLINTON TOWNSHIP, MI 48035
(586) 790-9003
(586) 493-3603
Mailing address
36500 S GRATIOT AVE, STE. 102, CLINTON TOWNSHIP, MI 48035-1772
(586) 790-9003
(586) 493-3603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101014297
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
5101013302
MI
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/13/2006
Last updated
05/24/2018
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