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Organization
BERRIOS ANTUNA FAMILY PRACTICE, PC
Active
Organization
BERRIOS ANTUNA FAMILY PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILIO J BERRIOS-ANTUNA MD (OWNER)
(313) 574-9266
Entity
Organization
Contact information
Practice address
6224 MICHIGAN AVE, DETROIT, MI 48210-2953
(313) 574-9266
Mailing address
6224 MICHIGAN AVE, DETROIT, MI 48210-2953
(313) 574-9266
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4301088825
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301088825
LICENSE NUMBER
MI
Enumeration date
02/20/2009
Last updated
12/21/2015
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