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Organization

BROOKSIDE INTERNAL MEDICINE, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELAINA VAYNTRUB M.D. (PRESIDENT/OWNER)
(248) 919-1100
Entity
Organization

Contact information

Practice address
24230 KARIM BLVD, SUITE 130, NOVI, MI 48375-2960
(248) 919-1100
Mailing address
24230 KARIM BLVD, SUITE 130, NOVI, MI 48375-2960
(248) 919-1100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301073103
MI

Other

Enumeration date
01/23/2009
Last updated
01/23/2009
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