# GREAT LAKES CANCER MGMT SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JEROME E SEID MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427155357
- **Authorized official:** ROXANNE CLARK (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (313) 884-5524

## Contact information

- **Practice address:** 11051 HALL RD, STE 120, UTICA, MI 48317-5735
- **Practice address phone:** (586) 991-0700
- **Practice address fax:** (586) 991-0701
- **Mailing address:** 11051 HALL RD, STE 120, UTICA, MI 48317-5735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 4301056352 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020