Organization
CANTON MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIDA LATIF MD (OWNER)
(269) 548-9602
Entity
Organization
Contact information
Practice address
37662 FORD RD, WESTLAND, MI 48185-1924
(734) 238-3800
(734) 238-3803
Mailing address
37662 FORD RD, WESTLAND, MI 48185-1924
(734) 238-3800
(734) 238-3803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235144759
NPI
MI
Enumeration date
01/29/2020
Last updated
02/07/2023
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