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Organization
MOLINA MEDICAL GROUP OF MICHIGAN, PC
Active
Organization
MOLINA MEDICAL GROUP OF MICHIGAN, PC
Active
Other names
Avalon Health Center, Avalon Health Center-Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
J MARIO MOLINA MD (OWNER)
(562) 499-6191
Entity
Organization
Contact information
Practice address
4700 SCHAEFER RD, DEARBORN, MI 48126-3655
(313) 581-2600
(313) 581-0228
Mailing address
4700 SCHAEFER RD, DEARBORN, MI 48126-3655
(313) 581-2600
(313) 581-0228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/26/2017
Last updated
07/21/2022
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