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Organization
THORACIC SURGICAL SERVICES, PC
Active
Organization
THORACIC SURGICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA WALL (BILLER)
(248) 296-0118
Entity
Organization
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(248) 676-2582
Mailing address
2186 CRANE ST, WATERFORD, MI 48329-3721
(248) 296-0118
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
12/16/2019
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