Organization
GREAT LAKES MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMAD RAHBAR M.D. (PRESIDENT)
(313) 418-9952
Entity
Organization
Contact information
Practice address
19070 E 10 MILE RD, EASTPOINTE, MI 48021-1449
(313) 418-9952
Mailing address
19070 E 10 MILE RD, EASTPOINTE, MI 48021-1449
(313) 418-9952
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5315012655
MI
Other
Enumeration date
08/15/2015
Last updated
08/15/2015
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