# MACOMB INTERNAL MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639266885
- **Authorized official:** MARY GUNST (OFFICE MANAGER)
- **Authorized official phone:** (586) 228-1010

## Contact information

- **Practice address:** 15520 19 MILE RD, SUITE 480, CLINTON TWP, MI 48038-6333
- **Practice address phone:** (586) 228-1010
- **Practice address fax:** (586) 228-8570
- **Mailing address:** 15520 19 MILE RD, SUITE 480, CLINTON TWP, MI 48038-6333
- **Mailing address phone:** (586) 228-1010
- **Mailing address fax:** (586) 228-8570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 04/18/2022