Organization
MCLAREN MACOMB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS M BRISSE (CEO)
(586) 493-8083
Entity
Organization
Contact information
Practice address
1000 HARRINGTON BLVD., ATTN: SPECIAL CARE NURSERY, MT. CLEMENS, MI 48043
(586) 493-8296
(586) 741-4114
Mailing address
1000 HARRINGTON BLVD., ATTN: SPECIAL CARE NURSERY, MT. CLEMENS, MI 48043-2920
(586) 493-8296
(586) 741-4114
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301085002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4819971
—
MI
Enumeration date
05/23/2006
Last updated
05/23/2018
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